Hirsutism Flashcards
1
Q
Etiology? Androgen
A
1 increased androgen Glandular ... Ovary.. PCO or tumor Adrenal.. cushing $, CAH, tumor EXTRA increased I HYPERPRO IATROGENIC..anabolic steroids, danazol
2
Q
Etiology? SHBG
A
Decreased SHBG liver disease Hypothyroidism Acromegaly Obesity
3
Q
Etiology? Estrogen
A
Decreased estrogen
1ry ovarian failure… resistant ovary $, turner
2ry …. HPF
4
Q
Etiology? Familial
A
Increased 5alpha reductase enzyme, increased 5 DHT receptor
5
Q
C/p?
A
Virilization: male hair distribution Hoarseness of voice Hypertrophy of SM, clitoris Breast atrophy Habitus of males NON... Acne, alopecia, altered libido, anovulation
6
Q
INVESTIGATIONS?
A
Lab.. testosterone N 0.2 - 0.8 ng/ml
..<200 .. not tumor PCO.. US, LH/FSH
..>200 tumor
DHEA N. 0.8-3.9 ng/ml
..<700 not tumor
..>700 tumor
7
Q
TTT? First line
A
COCS? E.. increase SHBG
P.. decrease LH ..androgen
8
Q
TTT? 2nd
A
Anti androgen +6 months
Finsteride -5 alpha reductase ENZ.
Spironolactone - 5DHT Receptor
Cyproterone acetate … P and antiandrogen
TERATOGENIC
9
Q
TTT? Other
A
GNRH
METFORMIN
Dexamethasone
