Lecture 21: PCOS

Question 1

What is PCOS?

Answer 1

Polycystic Ovarian Syndrome

Question 2

What is associated with PCOS?

Answer 2

• Often presents with insulin resistance
• not always associated with obesity
• major risk factor for: type 2 diabetes, gestational diabetes and cardiovascular disease

Question 3

What was the ‘91 criteria for PCOS?

Is it one or all of the following?

Answer 3

• Hyperandrogenism
• Chronic anovulation
• Exclusion of known disorders
  All of the following

Question 4

What is the ‘03 criteria for PCOS?

Is it one or all of the criteria?

Answer 4

• Hyperandrogenism
• Chronic anovulation
• Polycystic ovaries
  2 of the 3 following

Question 5

What is Polycystic ovaries?

Answer 5

enlarged ovaries containing at least 12 follicles each

Question 6

Ovarian Hyperandrogenism

Pulsatile _____ release is essential for maintenance for ______ release

Answer 6

GnRH

Gonadotropin

Question 7

Ovarian Hyperandrogenism

Frequency of ____ pulses determines which ________ hormone is preferentially synthesized.

Answer 7

GnRH

Gonadotropin

Question 8

Ovarian Hyperandrogenism
_____ GnRH pulses favor ___
_____ GnRH pulses favor ___

Answer 8

Rapid; LH

Slower: FSH

Question 9

Ovarian Hyperandrogenism
PCOS patients have ______ GnRH pulsatility.
Increased pulsatility favors ____ over ____ (ratio of __:___>_)

Answer 9

increased.
LH; FSH
LH: FSH; 1

Question 10

Ovarian Hyperandrogenism

Increased ___:___ ratio favors ______ production with less ________ to _______ by granulosa cells.

Answer 10

FSH: LH; androgen

aromatization; estrogen

Question 11

Ovarian Hyperandrogenism

What are some of the consequences of Androgen excess? (3)

Answer 11

• Hirsutism
• Acne
• Androgenic Alopecia

Question 12

What are ovarian cysts?

how do they show up on an ultrasound?

Answer 12

• small fluid-filled sacs that develop in the ovaries

- show up in a black color

Question 13

Ovarian cysts are only cancerous?

T/F

Answer 13

False; they can be both cancerous and noncancerous

Question 14

What are follicular cysts?

Answer 14

• noncancerous cysts

- forms when ovulation does not occur or when a mature follicle collapses on itself

Question 15

Women with PCOS have large number of:

Answer 15

small follicular cysts

Question 16

Insulin Resistance with PCOS
PCOS subjects are insulin resistance compared to controls with similar:
Obesity confers additional:

Answer 16

BMI

Insulin resistance

Question 17

What are some metabolic pathways for insulin resistance signaling?

Answer 17

energy storage:

• Glucose Uptake
• Glycogen Synthesis
• Fatty Acid Synthesis

Question 18

What are some mitogenic pathways for insulin resistance signaling?

Answer 18

Growth, Differentiation, Cell proliferation

• Protein synthesis
• Gene Expression

Question 19

Insulin has _____ (_______) actions.
_____-phosphorylated insulin receptor (__), phosphorylates ______ substrates, such as ___ and ___, initiating ______ ______ _____

Answer 19

pleiotropic; (multiple)
tyrosine, IR
Intracellular, IRS
Shc, signal transduction pathways