PCOS Diagnosis and Treatment
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Questions and Answers

What is the minimum ovarian volume required to diagnose PCOS according to Adam's criteria?

  • 12 cm3
  • 5 cm3
  • 15 cm3
  • 10 cm3 (correct)
  • What is the effect of weight reduction on insulin resistance in PCOS patients?

  • Decreases insulin resistance (correct)
  • Increases hyperandrogenism
  • Has no effect on insulin resistance
  • Increases insulin resistance
  • What is the treatment of choice for irregular uterine bleeding in PCOS patients?

  • D&C or hysterectomy (correct)
  • Diane
  • Bilateral laparoscopic ovarian drilling
  • Combined Oral Contraception
  • What is the purpose of bilateral laparoscopic ovarian drilling in PCOS patients?

    <p>To induce ovulation</p> Signup and view all the answers

    What is the effect of smoking on adrenal androgen in PCOS patients?

    <p>Increases adrenal androgen</p> Signup and view all the answers

    What is the treatment of choice for hirsutism in PCOS patients?

    <p>Combined Oral Contraception</p> Signup and view all the answers

    What is the primary effect of excessive LH secretion on ovarian function?

    <p>Stimulation of androgen production</p> Signup and view all the answers

    Which of the following is NOT a long-term risk of PCOS?

    <p>Type I diabetes mellitus</p> Signup and view all the answers

    What is the primary role of insulin-like growth factor (ILGF) in PCOS?

    <p>Stimulation of androgen synthesis</p> Signup and view all the answers

    According to the Rotterdam criteria, how many of the following characteristics must be present for a diagnosis of PCOS?

    <p>At least two</p> Signup and view all the answers

    What is the effect of androgen excess on the hypothalamic-pituitary-ovarian axis?

    <p>Inhibition of hypothalamic inhibitory feedback by progesterone</p> Signup and view all the answers

    What is the primary mechanism of insulin resistance in PCOS?

    <p>Decreased insulin receptor sensitivity</p> Signup and view all the answers

    What is the role of aromatase enzyme in ovarian function?

    <p>Conversion of androgens to estrogens</p> Signup and view all the answers

    What is the primary criterion for diagnosing PCOS, according to Adam's criteria?

    <p>Polycystic ovaries on ultrasound</p> Signup and view all the answers

    What is the underlying cause of anovulation in the hypothalamic-pituitary-ovarian axis?

    <p>Imbalance of hormones</p> Signup and view all the answers

    What is the definition of polycystic ovarian syndrome (PCOS)?

    <p>A hormonal disorder causing chronic anovulation and hyperandrogenism</p> Signup and view all the answers

    What is the primary cause of polycystic ovarian syndrome (PCOS)?

    <p>Unknown, with multiple possible causes</p> Signup and view all the answers

    What is the role of the hypothalamic-pituitary-ovarian (HPO) axis in ovulation?

    <p>It terminates in the ovaries, controlling ovulation</p> Signup and view all the answers

    What is the relationship between anovulation and polycystic ovaries?

    <p>Polycystic ovaries are a manifestation of a larger disease process, including anovulation</p> Signup and view all the answers

    What is the likely time of origin of polycystic ovarian syndrome (PCOS)?

    <p>During puberty</p> Signup and view all the answers

    Study Notes

    PCOS Diagnosis

    • Adam's criteria for PCOS diagnosis:
      • Ovarian volume > 10 cm3
      • Multiple follicles (≥ 10-12)
      • Microcysts
    • Rotterdam criteria for PCOS diagnosis:
      • Presence of 2 or more of:
        • Oligo or anovulation and menstrual dysfunction
        • Clinical and/or biochemical hyperandrogenism
        • Ovarian size and morphology on ultrasound

    Pathophysiology of PCOS

    • PCOS originates possibly at the time of puberty due to interplay of:
      • Obesity and excess of ovarian androgen production
      • Hyperinsulinemia and insulin resistance
      • Intrauterine environment
      • Genetic factors
    • Abnormalities in the hypothalamic-pituitary-ovarian axis:
      • Increased GnRH from hypothalamus
      • Excessive LH secretion relative to FSH by pituitary gland
      • LH stimulates ovarian thecal cells-- androgen production

    Symptoms and Characteristics of PCOS

    • Acanthosis nigricans: a velvety, darkening of the skin
    • Bilateral enlarged ovaries
    • Symmetrically enlarged uterus
    • Obesity (in 50% of females with PCOS)

    Treatment of PCOS

    • General measures:
      • Stop smoking
      • Weight reduction to decrease insulin resistance and hyperandrogenism
    • If pregnancy is desired:
      • Medical: Induction of ovulation
      • Surgical: Bilateral laparoscopic ovarian drilling (cauterization)
    • If pregnancy is not desired:
      • Treatment according to the main complaint:
        • Irregular cycles: Combined Oral Contraception
        • Irregular uterine bleeding: Medical treatment or Surgical treatment (D&C or hysterectomy)
        • Hirsutism: Combined Oral Contraception or Diane

    Long-term Risks of PCOS

    • Endometrial hyperplasia and carcinoma
    • Insulin resistance: Type II diabetes mellitus and hypertension
    • Dyslipidemia (increased LDL, triglycerides, and decreased HDL) leading to coronary heart disease

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    Description

    This quiz covers the diagnosis and treatment of Polycystic Ovary Syndrome (PCOS), including Adam's criteria, symptoms, and general measures for management.

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