Polycystic Ovarian Syndrome Flashcards

1
Q

What is the definition of PCOS?

A

Defined by at least 2 out of the 3:

  1. Anovulation
  2. Hyperandrogenism
  3. Polycystic ovaries on ultrasound
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2
Q

What are the other possible causes we need to exclude that can cause hyperandrogenism?

A
  1. Cushing syndrome
  2. Congenital adrenal hyperplasia
  3. Androgen secreting tumours
  4. Thyroid abnormalities
  5. Hyperprolactinaemia
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3
Q

What is the prevalence or incidence for PCOS?

A

3-11%

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4
Q

What is the clinical presentation of the patients that present with PCOS?

A
  1. Menstrual irregularities
  2. Young
  3. Obese
  4. Infertility
  5. Hirsutuism
  6. Alopecia
    7.
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5
Q

What are the signs of an irregular menstruation/anovulation?

A
  1. <8 cycles per year
  2. Periods lasting <26 days or >35 days
  3. Day 22-24 being less than 4ng/ml in progesterone
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6
Q

What are the signs of Hirsuitism?

A
  1. Deep voice
  2. Excessive hair growth
  3. Alopecia
  4. Acne
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7
Q

What do we find on ultrasound in regards to PCOS?

A
  1. Follicles that are >12 on the ovaries measuring 2-9mm

2. The ovary volumes can be >10cm3

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8
Q

How do we diagnose metabolic syndrome?

A

Based on at least 3 out of the 5:

  1. Waist circumference of >88cm
  2. BP of >130/85
  3. HDL <1,3
  4. Triglycerides >1,8
  5. HGT: fasting >6-7
    2hr: >7,8-11,1
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9
Q

What is the medical treatment for patients with PCOS?

A
  1. Encourage patient to lose weight
  2. Clomiphene citrate (oestrogen antagonist on the pituitary gland)
  3. Addition of dexamethasone
  4. Letrozole/anastrozole (aromatase inhibitors)
  5. Insulin sensitizers (metformin)
  6. \gonadotropin therapy
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10
Q

What is the surgical treatment for PCOS?

A
  1. Ovary drilling

2. 3 punctures made on each ovary

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