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GYN > PCOS > Flashcards

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

A

False.

22
Q

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

A

True

23
Q

MC age group for PCOS

A

reproductive age group

24
Q

PCOS is rare in which age group

A

Prepubertal

25
Q

Risk Factor for Prepubertal PCOS

A

Early onset of Adrenarche
Obesity with Acanthosis
LBW
Heterosexual Precocious puberty .

26
Q

Necklace pattern on USG is not a diagnostic criteria for PCOS . T or F

A

True

27
Q

Ovaries can appear normal on USG in PCOS. T or F

A

true

28
Q

HAIR - AN syndrome

A

HyperAndrogenism
Insulin Resistance
Acanthosis Nigricans

29
Q

Metabolic X syndrome.

A 
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
Q

Syndromes associated with PCOS

A

HAIR - AN and Metabolic X syndrome.

31
Q

Complications of PCOS - Short term

A

Infertility

Hirsutism and irregular cycles

32
Q

Long term complications of PCOS - Long Term

A

Heart disease,
Hyper - Estrogenic conditions
DM, Obesity complications.
Non - alcoholic Steatohepatitis

33
Q

Mx of PCOS

A 
1st step - weight reductio
Insulin resistance  DOC - Metformin 
Irregular cycles - OCP 
Hirsutism - OCP 
Infertility - Letrozole > clomiphene citrate > Bromocriptine `
34
Q

DOC in PCOS for Infertility

A

Letrozole > C.C

35
Q

DOC for infertility in obese and insulin resistance PCOS

A

Letrozole > CC + Metformin

36
Q

DOC in PCOS infertility with inc Prolactin levels

A

CC + Bromocriptine

37
Q

2nd line of MX in Infertility in PCOS

A

HMG or Laparoscopic Ovarian drilling.

38
Q

3rd line in Mx of infertility in PCOS

A

Pulsatile GnRH

39
Q

S/E of Ovulation inducing drugs

A

OHSS, Multifetal pregnancy and menopause like symptoms

40
Q

Disadvantage of laparoscopic drilling

A

Premature ovarian failure

41
Q

Clomiphene citrate - Combination

A

enclomiphene + zuclomiphene

42
Q

Max dose of CC

A

100 mg/day

43
Q

CC - how is it given in ovulation induction

A

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
Q

S/E of CC

A

Menopause like symptoms

OHSS, Multifetal pregnancy, Inc risk of Ovarian cancer

45
Q

When should CC be stopped

A

Visual symptoms

46
Q

Letrozole - MOA

A

Aromatase inhibitor

Estrogen Antagonist

47
Q

CC- MOA

A

Estrogen Antagonist

48
Q

thick endometrium and thin cervical mucus seen in which ovulation inducing drug

A

Letrozole

49
Q

Thin endometrium and Thick cervical mucus is seen in which Ovulation inducing drug

A

CC

GYN (19 decks)

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