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Block 14 module 7 > Hyperandrogenism and PCOS > Flashcards

Hyperandrogenism and PCOS Flashcards

1
Q

glandular source of androgen

A

ovaries

adreanal glands

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2
Q

non glandular source of androgen

A

not necessarily produce but convert:
Skin
Fat celss

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3
Q

Main form of androgen and their site of production:

Ovaries

A

testosterone

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4
Q

Main form of androgen and their site of production:

adrenals

A

DHEAS

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5
Q

Main form of androgen and their site of production:

peripheral tissues

A

3a diol G

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6
Q

differentiate Bilogically inactive form vs biologically active form of testosterone

A

Bio inactive - bound to SHBG

Bio active - free/ bound to albumin

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7
Q

among the types of testosterone w/c one is used to assess hyperandrogenism

A

Bio active form

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8
Q

potent form of testosterone that causes effects to the target tissues

A

3 a diol G

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9
Q

occurs in women where there is increase in androgen lvls or excess

A

hyperandrogenism

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10
Q

manifestations of hyperandrogenism

A 
hirsutism
alopecia
acne
voice deepening
amenorrhea
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11
Q

abnormalities in the sebaceous component would lead to

A

acne

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12
Q

abnormalities in the piliary component would lead to

A

hirsutism (excessive growth)

alopecia (excessive shedding)

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13
Q

3 phases of hair growth

A

anagen
catagen
telogen

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14
Q

treatment for hirsutism

A 
oral contraceptives
progestins
GnRH agonist
Ketoconazole
spironolactone (anti-estrogen)
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15
Q

increased amt of body hair in its normal location

A

hypertrichosis

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16
Q

differentiate virilization from hirsutism in terms of testosterone lvls

A

hirustism - testosterone is mildly increased (<1.5)

viriliztion >2ng/ml

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17
Q

most common cause of hyperandrogenism

A

androgenic medications

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18
Q

examples of androgenic medications

A

testosterone
anabolic steroids
danazol
19-norprogestogens

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19
Q

abnormal gonadal development can be attributed to a defect in the

A

Y chromosome (whole or part)

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20
Q

solid ovarian tumor, usually unilateral that causes hyperandrogenism

A

luteoma

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21
Q

cystic tumor usually bilateral that causes hyperandrogenism

A

hyperreactio luteinalis

22
Q

px 37 wk AOG undergo CS. solid ovarian luteoma was seen intraop. what will you do?

A

If unruptured, do not remove, it will usually regress to normal

23
Q

the main problem in idiopathic hirsutism

A

increased 5 a reductase thereby increasing androgen production

24
Q

histollogy of the ovary shows nest of luteinized theca cells scattered throughout the stroma

A

stromal hyperthecosis

25
Q

mgt for stromal hyperthecosis

A

TAHBSO

26
Q

ovarian tumor of reproductive age

A

sertoli-leydig cell tumors

27
Q

ovarian neoplasm commonly on postmenopauseal

A

hilus cell tumors

28
Q

most common adrenal neoplasm

A

adrenal carcinoma

29
Q

forms of late onset 21 hydroxylase deficiency

A

CAH

LOHD

30
Q

most common cause of sexual ambiguity

A

CAH

31
Q

symptoms of LOHD

A

post pubertal oligomenorrhea/amenorrhea
prepubertal accelerated growth
familial tendency

32
Q

diagnosis of LOHD

A

17-hydroxyprogesterone lvl >8ng/L

ACTH stimulation test above normal but <8ng/L

33
Q

treatment for LOHD

A

corticosteroids

OCP

34
Q

CAH is deficient with these enzymes

A

21-hydroxylase

11B hydroxylase

35
Q

excessive cortisol production from adrenal neoplasm or excessive ACTH production from a pituitary tumor

A

Cushing’s disease

36
Q

diagnosis for cushing’s

A 
dexamethasone suppresion test
Liddle's test
plasma ACTH
24 hr urinary cortisol
late night salivary cortisol
37
Q

treatment for cushing’s

A

OCP ( cyproterone acetate)

anti-androgens (spironolactone, flutamide and finasteride)

38
Q

most common endocinopathy in women

A

PCOS

39
Q

triad of PCOS

A

oligo and/or anovulation/menstrual irregularty
clinical and/or biochem signs of hyperandrogenism
PCOS on UTZ

40
Q

UTZ findings in PCOS

A

10 or more peripherally oriented cystic structures showing as black pearl necklace

41
Q

increase in LH will increase androstenedione, more peripheral conversion into estrogen form (estrone) by

A

aromatase

42
Q

type of CA that will put px with elevated LH at risk

A

endometrial cancer

43
Q

how can decreased SHBG lead to anovulation and hirsutism

A

dec SHB means increase in free testosterone leading to atresia of follicles leading to anovulation and hirsutism

44
Q

consequences of PCOS

A 
infertility
endomet CA
ovarian CA
DM
HPN and CVD
metabolic syndrome (high chol and trigly lvl)
45
Q

best approach to improve peripheral insulin sensitivity

A

metformin (insulin sensitizing agent)

46
Q

drugs for induction of ovulation

A 
clomiphene citrate
aromatase inhibitors (letrozole and anastrazole)
injectable gonadotropin
47
Q

px with pcos given Clomiphene citrate but ineffective. what is the 2nd line treatment?

A

aromatase inhibitors (letrozole and anastrazole)

48
Q

what would u give to px with pcos who do not want to get pregnant but want to menstruate

A

medroxyprogesterone acetate

norethindorne

49
Q

these drugs suppresses ovarian steroidogenesis and is usesd to improve signs of hirsutism and lipid profile

A

Estrogen-progestin OCP

50
Q

last option for the treatment of metabolic and weight concerns in px with pcos

A

bariatric surgery

Block 14 module 7 (6 decks)

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