NSG 6430 ACTUAL 2026 TEST PAPER QUESTIONS AND
ANSWERS GRADED A+
✔✔GnRH Pulse Generator - ✔✔At the time of puberty, GnRH is secreted from the
GnRH pulse generator in the hypothalamus, leading to pituitary secretion of LH and
FSH and subsequent secretion of estradiol from the ovaries or testosterone from the
testes. The exact triggers are still incompletely understood, although new research has
elucidated new potential regulators and key players in the awakening of this system.
These include leptin, the genes GPR54/KiSS-1, as well as several neuropeptides and
neurotransmitters.
✔✔ADRENARCHE - ✔✔The increased secretion of androgens from the adrenal gland,
called adrenarche, in the prepubertal and pubertal periods is independent of HPG
changes.
✔✔What is the Local conversion of DHEA-S to testosterone and then to
dihydrotestosterone is responsible for? - ✔✔-hair growth in the androgen-dependent
areas (face, chest, pubic area, axillae). Axillary and pubic areas are the most sensitive
to the effects of androgens, which is why these areas are the first to develop sexual
hair.
-local conversion of DHEA-S within the apocrine glands of the axillae causes body odor,
-conversion within sebaceous glands is responsible for the development of acne.
✔✔What is the height spurt during puberty attributed to? - ✔✔primarily upon growth
hormone and the insulin-like growth factors, but many other hormones may influence
growth as well, especially the sex steroids. Without prompt recognition and treatment,
premature or delayed puberty may have marked effects on height.
✔✔What is most linear growth contributed to? - ✔✔Growth hormone and its feedback
loop
✔✔GH during Puberty - ✔✔GH secretion is increased by growth hormone-releasing
hormone (GHRH) and decreased by somatostatin from the hypothalamic arm of the
loop. Growth hormone has been shown to double during the pubertal growth spurt. Like
many hormones, GH is secreted in pulsatile fashion, with maximum rates at the onset of
slow-wave sleep. It is this pulsatile secretion that renders random testing of GH
unhelpful. GH exerts its effects through IGFs, mainly IGF-I (formerly somatomedin-C)
and IGF-II.
✔✔Prediction of Final Height for girls - ✔✔(fathers height-13 cm or 5 inches) + mothers
height/2
✔✔Growth Velocity during puberty - ✔✔Growth velocity during the pubertal growth spurt
is at its highest levels outside of infancy. It should be noted that in calculating growth
velocity, it is important to have an interval of 6 to 12 months, as growth is greatest in the
,spring and summer months. Although males and females are roughly the same height
upon entry into puberty, males emerge taller by 13 cm on average. This is primarily due
to boys' 2-year lag behind girls in attaining their peak height velocity, but a small amount
of height may be accounted for by the higher peak velocity. Girls gain their peak height
velocity of 8.3 cm/year at an average age of 11.5 years (Tanner stages B2 to B3) while
boys do not reach their peak height velocity of 9.5 cm/year until the age of 13.5 years
(at Tanner genital stages 3 to 4). There are also curves available for early and late
maturers.
✔✔Prediction of final height for boys - ✔✔(fathers height + 13 cm or 5 inches) +
mothers height / 2
✔✔Bayley-Pinneau Method. for predicting height - ✔✔This technique uses bone age to
predict final height. It is based on the attainment of a bone age, on x-ray of the left hand
and wrist, that is then matched to standards.
✔✔how does the sex steroid Gonadal steroids effect height in puberty? - ✔✔contribute
to the growth spurt by inducing an increase in GH secretion and stimulating local
production of IGF-1 in cartilage and bone directly
✔✔How does the sex steroid Estrogen effect height in puberty? - ✔✔the hormone most
involved with the growth spurt via its effects on bone and cartilage in men and women.
✔✔How does the sex steroid Estradiol effect growth in puberty? - ✔✔Estradiol
concentration correlates with the pubertal growth spurt; girls experience an increase in
estradiol earlier than boys and achieve the corresponding increase in peak height
velocity earlier as well
✔✔how do androgens effect growth during puberty? (PG 11) - ✔✔have little direct
effect on pubertal bone growth. Androgens have a role in the sexual dimorphism of the
skeleton and are likely responsible for the greater increase in periosteal bone deposition
and therefore bone strength in men as compared with women.
✔✔Men vs woman in lean body mass and bone mass at end of puberty? - ✔✔men
have 1.5 times more lean body mass and skeletal mass than women and women have
double the fat mass.
✔✔What are Major determinants of Bone Mineral Density (BMD) - ✔✔physical activity
level, heredity, nutrition, endocrine function, and other lifestyle factors.
✔✔How does Age of menarche effect bone mass - ✔✔There is an inverse relationship
between the age of menarche and the risk of osteoporosis later in life, as demonstrated
by epidemiologic studies.
, ✔✔What serves as the "bone bank" for the remainder of life? - ✔✔accretion of skeletal
bone mass during puberty is critical, and peak bone mass is acquired by early
adulthood
✔✔How does Nutrition effect bone mass? - ✔✔Adequate consumption of calcium and
vitamin D is important for optimal accrual of bone mass. It appears that calcium intakes
of between 1,200 and 1,800 mg per day result in maximal calcium absorption for
children between 9 and 18 years of age.
✔✔How does Exercise effect bone mass? - ✔✔Weight-bearing physical activity during
pre- and early puberty has been shown to improve bone strength, but results have been
less promising for the effects of exercise on postmenarcheal girls.
✔✔How does hormonal control effect bone mass? - ✔✔The skeletal structure also
undergoes epiphyseal maturation under the influence of estradiol and testosterone, as
reviewed above
✔✔What are the phases of adolescence? - ✔✔(1) early adolescence: approximate ages
10 to 13, or middle school years;
(2) middle adolescence: approximate ages 14 to 17, or high school years;
(3) late adolescence: approximate ages 17 to 21, or college or 4 years of work after high
school.
✔✔How is bone age determined? - ✔✔determined by comparing a radiograph of an
adolescent's hand, wrist, or knee to standards of maturation in a normal population
✔✔Is intractable and major conflict between parents and their adolescent children a
"normal" part of adolescence? - ✔✔NO
✔✔Independence-Dependence Struggle LATE ADOLESCENCE (APPROXIMATE
AGES 17 TO 21) - ✔✔(1) a firmer identity;
(2) a greater ability to delay gratification;
(3) an improved ability to think ideas through and express ideas in words;
(4) more stable interests; and
(5) a greater ability to make independent decisions and to compromise.
✔✔Tasks that characterize the development of adolescents - ✔✔(1) achieving
independence from parents;
(2) adopting peer codes and lifestyles;
(3) assigning increased importance to body image and accepting one's body image; and
(4) establishing sexual, ego, vocational, and moral identities.
✔✔Common events of independence-dependence in EARLY ADOLESCENCE
(APPROXIMATE AGES 10-13) - ✔✔(1) less interest in parental activities and more
ANSWERS GRADED A+
✔✔GnRH Pulse Generator - ✔✔At the time of puberty, GnRH is secreted from the
GnRH pulse generator in the hypothalamus, leading to pituitary secretion of LH and
FSH and subsequent secretion of estradiol from the ovaries or testosterone from the
testes. The exact triggers are still incompletely understood, although new research has
elucidated new potential regulators and key players in the awakening of this system.
These include leptin, the genes GPR54/KiSS-1, as well as several neuropeptides and
neurotransmitters.
✔✔ADRENARCHE - ✔✔The increased secretion of androgens from the adrenal gland,
called adrenarche, in the prepubertal and pubertal periods is independent of HPG
changes.
✔✔What is the Local conversion of DHEA-S to testosterone and then to
dihydrotestosterone is responsible for? - ✔✔-hair growth in the androgen-dependent
areas (face, chest, pubic area, axillae). Axillary and pubic areas are the most sensitive
to the effects of androgens, which is why these areas are the first to develop sexual
hair.
-local conversion of DHEA-S within the apocrine glands of the axillae causes body odor,
-conversion within sebaceous glands is responsible for the development of acne.
✔✔What is the height spurt during puberty attributed to? - ✔✔primarily upon growth
hormone and the insulin-like growth factors, but many other hormones may influence
growth as well, especially the sex steroids. Without prompt recognition and treatment,
premature or delayed puberty may have marked effects on height.
✔✔What is most linear growth contributed to? - ✔✔Growth hormone and its feedback
loop
✔✔GH during Puberty - ✔✔GH secretion is increased by growth hormone-releasing
hormone (GHRH) and decreased by somatostatin from the hypothalamic arm of the
loop. Growth hormone has been shown to double during the pubertal growth spurt. Like
many hormones, GH is secreted in pulsatile fashion, with maximum rates at the onset of
slow-wave sleep. It is this pulsatile secretion that renders random testing of GH
unhelpful. GH exerts its effects through IGFs, mainly IGF-I (formerly somatomedin-C)
and IGF-II.
✔✔Prediction of Final Height for girls - ✔✔(fathers height-13 cm or 5 inches) + mothers
height/2
✔✔Growth Velocity during puberty - ✔✔Growth velocity during the pubertal growth spurt
is at its highest levels outside of infancy. It should be noted that in calculating growth
velocity, it is important to have an interval of 6 to 12 months, as growth is greatest in the
,spring and summer months. Although males and females are roughly the same height
upon entry into puberty, males emerge taller by 13 cm on average. This is primarily due
to boys' 2-year lag behind girls in attaining their peak height velocity, but a small amount
of height may be accounted for by the higher peak velocity. Girls gain their peak height
velocity of 8.3 cm/year at an average age of 11.5 years (Tanner stages B2 to B3) while
boys do not reach their peak height velocity of 9.5 cm/year until the age of 13.5 years
(at Tanner genital stages 3 to 4). There are also curves available for early and late
maturers.
✔✔Prediction of final height for boys - ✔✔(fathers height + 13 cm or 5 inches) +
mothers height / 2
✔✔Bayley-Pinneau Method. for predicting height - ✔✔This technique uses bone age to
predict final height. It is based on the attainment of a bone age, on x-ray of the left hand
and wrist, that is then matched to standards.
✔✔how does the sex steroid Gonadal steroids effect height in puberty? - ✔✔contribute
to the growth spurt by inducing an increase in GH secretion and stimulating local
production of IGF-1 in cartilage and bone directly
✔✔How does the sex steroid Estrogen effect height in puberty? - ✔✔the hormone most
involved with the growth spurt via its effects on bone and cartilage in men and women.
✔✔How does the sex steroid Estradiol effect growth in puberty? - ✔✔Estradiol
concentration correlates with the pubertal growth spurt; girls experience an increase in
estradiol earlier than boys and achieve the corresponding increase in peak height
velocity earlier as well
✔✔how do androgens effect growth during puberty? (PG 11) - ✔✔have little direct
effect on pubertal bone growth. Androgens have a role in the sexual dimorphism of the
skeleton and are likely responsible for the greater increase in periosteal bone deposition
and therefore bone strength in men as compared with women.
✔✔Men vs woman in lean body mass and bone mass at end of puberty? - ✔✔men
have 1.5 times more lean body mass and skeletal mass than women and women have
double the fat mass.
✔✔What are Major determinants of Bone Mineral Density (BMD) - ✔✔physical activity
level, heredity, nutrition, endocrine function, and other lifestyle factors.
✔✔How does Age of menarche effect bone mass - ✔✔There is an inverse relationship
between the age of menarche and the risk of osteoporosis later in life, as demonstrated
by epidemiologic studies.
, ✔✔What serves as the "bone bank" for the remainder of life? - ✔✔accretion of skeletal
bone mass during puberty is critical, and peak bone mass is acquired by early
adulthood
✔✔How does Nutrition effect bone mass? - ✔✔Adequate consumption of calcium and
vitamin D is important for optimal accrual of bone mass. It appears that calcium intakes
of between 1,200 and 1,800 mg per day result in maximal calcium absorption for
children between 9 and 18 years of age.
✔✔How does Exercise effect bone mass? - ✔✔Weight-bearing physical activity during
pre- and early puberty has been shown to improve bone strength, but results have been
less promising for the effects of exercise on postmenarcheal girls.
✔✔How does hormonal control effect bone mass? - ✔✔The skeletal structure also
undergoes epiphyseal maturation under the influence of estradiol and testosterone, as
reviewed above
✔✔What are the phases of adolescence? - ✔✔(1) early adolescence: approximate ages
10 to 13, or middle school years;
(2) middle adolescence: approximate ages 14 to 17, or high school years;
(3) late adolescence: approximate ages 17 to 21, or college or 4 years of work after high
school.
✔✔How is bone age determined? - ✔✔determined by comparing a radiograph of an
adolescent's hand, wrist, or knee to standards of maturation in a normal population
✔✔Is intractable and major conflict between parents and their adolescent children a
"normal" part of adolescence? - ✔✔NO
✔✔Independence-Dependence Struggle LATE ADOLESCENCE (APPROXIMATE
AGES 17 TO 21) - ✔✔(1) a firmer identity;
(2) a greater ability to delay gratification;
(3) an improved ability to think ideas through and express ideas in words;
(4) more stable interests; and
(5) a greater ability to make independent decisions and to compromise.
✔✔Tasks that characterize the development of adolescents - ✔✔(1) achieving
independence from parents;
(2) adopting peer codes and lifestyles;
(3) assigning increased importance to body image and accepting one's body image; and
(4) establishing sexual, ego, vocational, and moral identities.
✔✔Common events of independence-dependence in EARLY ADOLESCENCE
(APPROXIMATE AGES 10-13) - ✔✔(1) less interest in parental activities and more
