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PCOS Flashcards

1
Q

PCOS aka

A

Stein Leventhal syndrome

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2
Q

PCOS.?

A

Excessive androgen production from Ovary

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3
Q

Features of PCOS

A

Hirsutism , Male pattern baldness, inc LDL , Dec HDL and Risk of Heart diseases .

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4
Q

PCOS is MC in

A

Obese female

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5
Q

E1 : E2 ratio in Females with PCOS

A

2:1

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6
Q

E2 : E1 raion in Females with PCOS

A

1:2

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7
Q

normal FSH : LH levels

A

FSH < LH

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8
Q

FSH : LH in PCOS

A

1 : 2 or 1 : 3

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9
Q

LH surge in PCOS

A

Absent - Consistently high levels of LH

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10
Q

inc LH in Early part of cycle leads to

A

Anovulation and Theca cell hypertrophy - Inc androgen levels.
Infertility, Absent or reduced progesterone and Necklace pattern on USG

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11
Q

After puberty, Granulosa cell of small Follicles produce

A

Anti Mullerian Hormone.

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12
Q

In PCOS , No corpus luteum and Dec progesterone causes

A

Secondary amenorrhea and Anovulatory or Irregular cycles.

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13
Q

Insulin Resistance in PCOS manifests as

A

Acanthosis Nigricans

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14
Q

Acanthosis Nigricans

A

Hyper pigmented skin in axillary area or nape of the neck

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15
Q

Investigations for Insulin resistance

A

Serum fasting glucose levels / Serum fasting insulin levels

IF < 4.5 = Insulin resistance

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16
Q

Hormones INC in PCOS

A 
Estrogen
LH , 
Androgens 
LDL 
AMH
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17
Q

Hormones DEC in PCOS

A

Progesterone
FSH
HDL
SHBG

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18
Q

TSH, Prolactin and inhibin level in PCOS

A

normal

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19
Q

Diagnosis of PCOS

A

Rotterdam criteria

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20
Q

Rotterdam criteria

A

Any 2 of the following .

1) Hyperandrogenism - Hirsutism - Biochemically high levels
2) Ovulatory dysfunction - Anovulatory or irregular cycles or amenorrhea
3) USG evidence - > 12 follicles ,< 1 cm in size follicle, Volume >10cc

21
Q

Obesity is a diagnostic criteria for PCOS - T or F

22
Q

LDL : HDL is not a diagnostic criteria for PCOS. T or F

23
Q

MC age group for PCOS

A

reproductive age group

24
Q

PCOS is rare in which age group

A

Prepubertal

25
Risk Factor for Prepubertal PCOS
Early onset of Adrenarche Obesity with Acanthosis LBW Heterosexual Precocious puberty .
26
Necklace pattern on USG is not a diagnostic criteria for PCOS . T or F
True
27
Ovaries can appear normal on USG in PCOS. T or F
true
28
HAIR - AN syndrome
HyperAndrogenism Insulin Resistance Acanthosis Nigricans
29
Metabolic X syndrome.
``` Abdominal obesity TGL > 150 mg/dl HDL <50 mg/dl BP >130/85 mmHg FBS - 110-126 mg/dl 2hr PP - 140 -199 mg/dl any 3 of the 5 should be present ```
30
Syndromes associated with PCOS
HAIR - AN and Metabolic X syndrome.
31
Complications of PCOS - Short term
Infertility | Hirsutism and irregular cycles
32
Long term complications of PCOS - Long Term
Heart disease, Hyper - Estrogenic conditions DM, Obesity complications. Non - alcoholic Steatohepatitis
33
Mx of PCOS
``` 1st step - weight reductio Insulin resistance DOC - Metformin Irregular cycles - OCP Hirsutism - OCP Infertility - Letrozole > clomiphene citrate > Bromocriptine ` ```
34
DOC in PCOS for Infertility
Letrozole > C.C
35
DOC for infertility in obese and insulin resistance PCOS
Letrozole > CC + Metformin
36
DOC in PCOS infertility with inc Prolactin levels
CC + Bromocriptine
37
2nd line of MX in Infertility in PCOS
HMG or Laparoscopic Ovarian drilling.
38
3rd line in Mx of infertility in PCOS
Pulsatile GnRH
39
S/E of Ovulation inducing drugs
OHSS, Multifetal pregnancy and menopause like symptoms
40
Disadvantage of laparoscopic drilling
Premature ovarian failure
41
Clomiphene citrate - Combination
enclomiphene + zuclomiphene
42
Max dose of CC
100 mg/day
43
CC - how is it given in ovulation induction
Given from D2-D6 or D5- D9 Then stopped - on D10 - follicular monitoring Wait for follicles to reach 18-20 mm - then on day 18 give Inj HCG - ovulation trigger 32-36 hrs later - Ovulation.
44
S/E of CC
Menopause like symptoms | OHSS, Multifetal pregnancy, Inc risk of Ovarian cancer
45
When should CC be stopped
Visual symptoms
46
Letrozole - MOA
Aromatase inhibitor | Estrogen Antagonist
47
CC- MOA
Estrogen Antagonist
48
thick endometrium and thin cervical mucus seen in which ovulation inducing drug
Letrozole
49
Thin endometrium and Thick cervical mucus is seen in which Ovulation inducing drug
CC

GYN (19 decks)

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