Hirsutism and Virilization

Question 1

Pt presents w irregular menses and hirsutism of 3 months with elevated DHEAS, what is most likely dx?

Answer 1

adrenal tumor

Question 2

Checking what level would rule out 21-hydroxylase deficiency?

Answer 2

17-hydroxyprogesterone

Question 3

What are first tests for Cushing’s syndrome?

Answer 3

dexamethasone suppression test or 24 hour urinary measurement for cortisol

Question 4

What causes hair loss after pregnancy?

Answer 4

high estrogen levels in pregnancy increase synchrony of hair growth; postpartum telogen effluvium affects 40-50% of women postpartum; therefore, hair grows in the same phase during pregnancy and is therefore shed at the same time which can result in significant postpartum hair loss at one to five months postpartum

Question 5

What is Sertoli-Leydig cell tumor?

Answer 5

testosterone secreting ovarian tumor that suppresses FSH and LH most commonly diagnosed between 20-40yo with signs thats include acne, hirsutism, amenorrhea, clitoral hypertrophy and deepening of voice

Question 6

what is hyperthecosis?

Answer 6

more severe form of PCOS associated with virilization due to high androstenedione production and testosterone levels

Question 7

what can be used in addition to OCPs for hirsutism?

Answer 7

spironolactone, an aldosterone antagonist diuretic