pcos

Question 1

rotterdam diagnostic criteria for pcos

Answer 1

2/3: anovulation, hyperandrogenism (clinical or labs), polycystic ovaries

Question 2

How do you define polycystic ovaries

Answer 2

Volume > 10 cm3, >12 antral follicles/ovary

Question 3

what labs are included in PCOS evaluation

Answer 3

progesterone, TSH, prolactin, Cycle day 3 FSH/LH/estradiol, lab assessment of hyperandrogenism

Question 4

how to diagnosis non classical CAH

Answer 4

17-OHP level! Follicular phase < 200 NEGATIVE, > 800 CONfirms. if in between, need ACTH stim test

Question 5

how to treat hirsuitism?

Answer 5

OCPs! (decrease LH increase SHBG decrease DHEAS, inhibit skin 5 alpha reduct), Spironolactone (aldosterone antago, best in combo with ocp), vaniqa (inhib ornithine decarboxylase- NOT USED ALONE), Finasteride (5 alpha reductase), Flutamide (androgen RB)

Question 6

best treatment for infertility in PCOS and MOA

Answer 6

ovulation induction. best with letrozole (aromatase inhib)

Question 7

physiology of PCOS

Answer 7

Cycle of high insulin and LH resulting in increased ovarian testostoerone production, high T results in inhibition of follicular maturation resulting in many small follicles and anovulation