Does PCOS increase the risk of developing type II diabetes?
Retrospective studies have shown a 2-5 fold increased risk of diabetes in women with PCOS when compared with control population
100
What is the role of Insulin in PCOS pathogenesis?
Insulin synergizes with LH to increase androgens, decreases synthesis of SHBG (thus increasing Testosterone)
200
Finish the quote:
"To the left, to the left..."
"...everything I own in a box to the left"
200
What percent reduction in weight is associated with improved ovulatory function?
2 to 7%
200
What labs should be done on a woman with amenorrhea? What is the most common cause of amenorrhea
bHCG
Pregnancy...!!!
200
How do you diagnose metabolic syndrome?
3 out of the 5
1. Hypertension (>130/85)
2. Increased weight circumference (> 35inches)
3. Insulin resistance (>100mg/dL fasting glucose)
4. Decreased HDL (<50mg/dL)
5. Elevated triglycerides (>150mg/dL)
200
What are the Androgen Excess Society Criteria (2006) for diagnosing PCOS?
Hyperandrogenism (required) and one of the two, oligomenorrhea/amenorrhea or polycystic ovaries on ultrasound.
300
What labs should you order for the work-up of PCOS?
Free testosterone (or total T and SHBG), TSH, prolactin, 17-hydroxyprogesterone, 2 hour glucose tolerance test, fasting lipid and lipoprotein level
300
Name two nonandrogenic progestins used in OCPs for treatment of androgen excess.
- Norgestimate
- Desogestrel
300
Commonly seen in PCOS, what is acanthosis nigricans and where can it be found?
Velvety, verrucous hyperpigmented skin most commonly found on the back of the neck, in the axillae, underneath the breasts and on the vulva.
300
Weight loss improves ovarian function in women with PCOS, true or false?
True! Weight loss can improve the fundamental aspects of the endocrine syndrome in PCOS by lowering circulating androgen levels and causing spontaneous resumption of menses. Studies have shown near normalization of ovarian function in PCOS women undergoing gastric bypass surgery as well as ovarian function improvement in women on orlistat, an intestinal lipid absorption inhibitor.
300
What is a big long-term concern for women with abnormal uterine bleeding?
Endometrial CA (due to unopposed estrogenic stimulation of the endometrium)
400
What hormone is released in a pulsatile fashion, is modulated by catecholamine secretion from the CNS and by feedback of sex steroids from the ovaries?
GnRH
400
How does Metformin decrease androgen production in women with PCOS?
Inhibits hepatic glucose production, necessitating a lower insulin concentration and reducing androgen production of theca cells
400
What is the most common cause of secondary amenorrhea?
Asherman's syndrome
400
What is a luteal phase defect?
The corpus luteum of the ovary is not fully developed to secrete adequate quantities of progesterone to support the endometrium for the usual 13-14 days.
400
Describe the 2 main mechanisms by which OCPs reduce androgen production?
- Estrogen suppresses LH, decreasing ovarian androgen production
- Estrogen increases hepatic production of sex hormone binding globulin, reducing the amount of free/unbound available to occupy the androgen receptor
500
Why is Finasteride, an anti-androgen, suboptimal for the treatment of hirsutism?
Inhibits TYPE 2 5-alpha reductase, however the majority of pilosebaceous units contain TYPE 1 5- alpha reductase
500
What topical agent has been approved for use in the treatment of facial hirsutism, and how does it work?
Eflornithine hydrochloride - inhibits ornithine decarboxylase in skin
500
What song did Beyonce perform at the 2016 Superbowl?
What is Formation
500
Describe the mechanism of action of Flutamide, an anti androgen.
Inhibits androgen uptake and binding to androgen receptors on target organs
500
Where was Beyonce's new album Lemonade first available? And explain what that is.