Hirsutism, Sertoli-Leydig Cell Tumor

Question 0

Signs of virilization?

Answer 0

1. Clitoromegaly
2. Deepening of voice
3. Balding
4. Increased muscle mass

Question 1

Most sensitive sign of excess androgen production?

Others?

Answer 1

Hirsutism

acne, oily skin, increased libido, virilization

Question 2

Differences in hair growth between ethnic groups are due to variations in?

Answer 2

Hair follicle concentration and 5-a-reductase activity

Question 3

Three stages of hair growth? Teach that determines hair length? Hair stability?

Answer 3

Anagen (growing phase)
Catagen (involution phase)
Telogen (quiescent please)

Anagen phase; telogen phase

Question 4

Effect of androgen on sex hormone binding globulin?

Answer 4

Decreases it

Question 5

Hirsutism; fast and recent growth versus slow and long-term growth?

Answer 5

Adrenal/ovarian tumors versus PCOS

Question 6

Virilization almost always suggests?

Answer 6

Androgen secreting Tumor (massive amounts of androgen)

Question 7

Congenital adrenal hyperplasia – most common defect?

Answer 7

21-hydroxylase

Question 8

Classic versus late-onset CAH?

Answer 8

Ambiguous genitalia in the newborn versus adult females with hirsutism and anovulation

Question 9

Cushing’s syndrome – history will have? Physical examination will show? Rule out with which lab test? Treatment?

Answer 9

Glucose intolerance;

Hypertension, buffalo hump, central obesity

Dexamethasone suppression test

Surgery

Question 10

Adrenal tumor – history will have? Physical examination will show? Rule out with which lab test? Treatment

Answer 10

Rapid onset virilization

Abdominal mass

DHEA-S

Surgery

Question 11

Congenital adrenal hyperplasia – history will have? Physical examination will show? Rule out with which lab test? Treatment

Answer 11

Ambiguous genitalia; family history

Hypotension

Elevated 17-hydroxyprogesterone

Cortisol and Mineralocorticoids

Question 12

PCOS – history will have? Physical examination will show? Rule out with which lab test? Treatment

Answer 12

Onset since menarche

Hirsutism, rarely virilization

Elevated LH/FSH ratio

OCP

Question 13

Sertoli-Leydig cell tumor – history will have? Physical examination will show? Rule out with which lab test? Treatment

Answer 13

Rapid onset

Hirsutism, virilization, adnexal mass

Elevated testosterone

Surgery

Question 14

Use of spironolactone disorders with excess androgen? Will help with? (But?)

Answer 14

Androgen antagonist; Hair growth (but average of six months before noticeable results

Question 15

Young girl with breast and vaginal development, but no hair growth. Mass noted. Most likely diagnosis?

Answer 15

Granulosa cell tumor