PCOS Flashcards
most common clinical presentation of hyperandrogenism?
hirsutism or acne
what are the adrenal causes of hyperandrogenism?
cushing
adrenal carcinoma
cong adrenal hyperplasia
what are the ovarian causes of hyperandrogenism?
pcos
hypertrichosis(severe variant of pcos)
ovarian tumor(sertoli-leydig tumor)
virilism can be seen more in which disease?
cushing
**why is virilism dangerous sign?
risk for ovarian or adrenal cancer
what is virilism?
condition in which women develop male** pattern hair and other physical activity growth such as deepening of voice, cliteromegaly, breast atrophy, amenorrhea
which is a result of adrenal or ovarian tumor
what is the condition that is known as the severe form of andregonism and is characterized by excessive terminal hair growth in androgen dep areas of women’s**(not man like in virilism) body
hirsutism
what condition is characterized by growth of non-pigmented hair and is not related to excessive androgen secretion?
hypertrichosis
most common cause of hyperandrogenism?
PCOS
etiology of hirsutism?
“CHHIICA with PCOS”
PCOS
Cong adrenal hyperplasia
Hyperprolactinemia
Hypo/Hyperthyroidism
Idiopathic hirsutism
Idiopathic hyperandrogenemia
Acromegaly
which system of scoring is used for dx of hirsutism?
Ferriman-gallwey >or equal to 8
***which criteria is used to dx PCOS?
Rotterdam criteria(must have at least 2/3)
1-hyperandrogenism
2-mestrual irregulations: olig-ovulation, anovulation…: <9cycles per year
3-polycystic ovaries on u/s
pathophysiology of PCOS?
1-insulin resistance and hyperinsulinemia, which lead to inc in LH and slight dec in FSH
2-environmental and genetic factors
**tx for pcos/hyperandrogenism?
-menstruation irregulation: OCS(supresses FSH and LH)
-Insulin res: metformin, diet, exercise
-hirsutism: OCS
+ antiandrogens(tx for hyperandrogenism)
OCS contraindications: pts with high INR/PTT , smokers, obese; instead give antiandrogens
what is the most common adrenal cause of hyperandrogenism?
CAH cong adrenal hyperplasia
**what are the most common enzymal deficiencies in CAH?
21 hydroxylase (90%)
11 hydroxylase (5%)
pathophysiology of 21 hydroxylase deficiency?
-dec cortisol
-dec aldosterone (bcz 21 is used to catalyze the hydroxylation of 17 hydroxyprogesterone to 11 deoxycortisol in glucocorticoid path to form cortisol and aldosterone)
-inc 17 hydroxyprogesterone substrate
-high testosterone
symptoms of 21 hydoxylase deficiency?
-hypotension->increased renin(compensation)
-hyperkalemia
-met acidosis
-female pseudohermaphroditism(accumulation of 17-hydroxyprog–>DHEA –>testosterone)
how to diagnose CAH?
measuring early morning basal 17-hydroxyprogesterone levels, if >1000ng/dl–> diagnostic for 21-hydroxylase deficiency caused CAH
what if levels are between 200 and 1000?–> measure ACTH to check for aldosterone and cortisol are low
