263. Hirutism, virilism, gynaecomastia and impotance

Question 1

What is hirsutism?

What causes it?

Answer 1

Male pattern hair growth in woman typically familial, idiopathic or due to increased androgen secretion by the ovaries (PCOS) the adrenal glands (cushing’s) or drugs

Question 2

What is the management of hirutism?

Answer 2

Manage underlying cause

Healthy eating, optimise weight, shaving, wax creams, bleach hair

CCP

Question 3

What is virilism?

What causes it?

Answer 3

Onset of amenorrhoea, clitoromegaly, deep voice, baldness and hirsutism

Typically caused by androgen secreting or ovarian tumour

Question 4

What are the differentials for gynaecomastia?

Answer 4

Hypogonadism
Liver cirrhosis
Hyperthyroidism
Tumours
Iatrogenic- oestrogens, spironolactone. digoxin, testosterone

Question 5

What are the causes to erectile dysfunction

Answer 5

Smoking, alcohol, diabetes (big three)

Hypognadism, hyperthyroidsim, increased prolactin

Psycholoogical e.g. stress

Iatrogenic

Damage during procedures

Question 6

How is erectile dysfunction treated?

Answer 6

Treat cause

Counselling

Oral pDE5 inihibtoors- increase No2 release which causes erections. SE include headache, flushing, dyspepsia

Question 7

Who shouldnt recieve DP5 inhibitors

Answer 7

Use of nitrates, Bp high or arrhythmias
Unstable angina/stroke
Recent MI
Degenerative retinal disorders