POLYCYSTIC OVARIAN SYNDROME
PCOS EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
some facts about PCOS and genetic etiology - ANSWER-- Males are likely involved in
genetic heritance but may be difficult to identify by outward signs or symptoms
- Studies of specific genes and association with PCOS have suggested candidates for
inheritance but ultimately have been largely disappointing
- Inheritance is likely polygenic
How do environmental factors play a role in PCOS - ANSWER-Environmental factors
may also play a role but exact influence is also unclear
- Weight gain can increase susceptibility to PCOS (but is weight gain genetic or
environmental?)
- Influence of intrauterine environment
how does intrauterine environment affect development of PCOS? - ANSWER-- Large
birth weight babies born to obese mothers have higher risk of PCOS than general
population
- Animal models have suggested relationship between in utero exposure to excess
androgens and later development of PCOS
-Women with PCOS have elevated levels of total and free (able to interact with
receptors) testosterone during pregnancy
PCOS likely involves _________________ and ___________________ but the
specifics are not understood yet. - ANSWER-genetic susceptibility and environmental
exposure
Multiple physiologic derangements in PCOS patients have been identified. What are
they? - ANSWER-- Insulin resistance
- Altered gonadotropin behavior
- Increased estrogen and androgen production from ovaries
Cause-and-effect relationships among these dysfunctional physiologic processes are
not well understood
What is the universally accepted criteria for diagnosis of PCOS? - ANSWER-trick
question, there is no universally accepted criteria for diagnosis
What is the most commonly accepted criteria for dx of PCOS? - ANSWER-Rotterdam
criteria (supported by NIH workshop)
, What does the rotterdam criteria require for the dx of PCOS? - ANSWER-requires any
two of three components
- Menstrual cycle irregularity (oligomenorrhea or amenorrhea)
- Polycystic ovaries by ultrasound
- Hyperandrogenism
What does androgen excess society criteria require for the dx of PCOS? - ANSWER-
requires hyperandrogenism and one of the remaining two criteria
- Menstrual cycle irregularity (oligomenorrhea or amenorrhea)
- Polycystic ovaries by ultrasound
What does rotterdam criteria include that androgen excess society excludes in their
criteria?
What difference does it make? - ANSWER-Rotterdam criteria includes milder forms
(non- hyperandrogenic) of PCOS which increases prevalence compared to Androgen
Excess Society criteria and may make comparison across studies difficult
What are 2 types of menstrual irregularities seen in women w/ PCOS? - ANSWER-
Oligomenorrhea
Amenorrhea
Define oligomenorrhea - ANSWER-- Nine or fewer menstrual cycles per year
- More than 38 days (~ 6 weeks) from start of menses to start of next menses
- Typically begins around onset of first menses (menarche) which may itself be delayed
define amenorrhea - ANSWER-- No menstrual cycles for three or more consecutive
months
What are irregular menses usually the result of? - ANSWER-anovulation (failed oocyte
production)
how does anovulation cause irregular menses? - ANSWER-- Ovulation is required to
form a corpus luteum which secretes progesterone
- Endometrial lining requires priming with progesterone to slough off in a predictable
fashion
What must you see on ultrasound to meet the rotterdam criteria of polycystic ovaries -
ANSWER-12 or more follicles 2-9 mm in diameter in each ovary or increased ovarian
volume
Are polycystic ovaries a common finding in women w/ PCOS? - ANSWER-yes,
extremely common
- 92% of patients with hirsutism
PCOS EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
some facts about PCOS and genetic etiology - ANSWER-- Males are likely involved in
genetic heritance but may be difficult to identify by outward signs or symptoms
- Studies of specific genes and association with PCOS have suggested candidates for
inheritance but ultimately have been largely disappointing
- Inheritance is likely polygenic
How do environmental factors play a role in PCOS - ANSWER-Environmental factors
may also play a role but exact influence is also unclear
- Weight gain can increase susceptibility to PCOS (but is weight gain genetic or
environmental?)
- Influence of intrauterine environment
how does intrauterine environment affect development of PCOS? - ANSWER-- Large
birth weight babies born to obese mothers have higher risk of PCOS than general
population
- Animal models have suggested relationship between in utero exposure to excess
androgens and later development of PCOS
-Women with PCOS have elevated levels of total and free (able to interact with
receptors) testosterone during pregnancy
PCOS likely involves _________________ and ___________________ but the
specifics are not understood yet. - ANSWER-genetic susceptibility and environmental
exposure
Multiple physiologic derangements in PCOS patients have been identified. What are
they? - ANSWER-- Insulin resistance
- Altered gonadotropin behavior
- Increased estrogen and androgen production from ovaries
Cause-and-effect relationships among these dysfunctional physiologic processes are
not well understood
What is the universally accepted criteria for diagnosis of PCOS? - ANSWER-trick
question, there is no universally accepted criteria for diagnosis
What is the most commonly accepted criteria for dx of PCOS? - ANSWER-Rotterdam
criteria (supported by NIH workshop)
, What does the rotterdam criteria require for the dx of PCOS? - ANSWER-requires any
two of three components
- Menstrual cycle irregularity (oligomenorrhea or amenorrhea)
- Polycystic ovaries by ultrasound
- Hyperandrogenism
What does androgen excess society criteria require for the dx of PCOS? - ANSWER-
requires hyperandrogenism and one of the remaining two criteria
- Menstrual cycle irregularity (oligomenorrhea or amenorrhea)
- Polycystic ovaries by ultrasound
What does rotterdam criteria include that androgen excess society excludes in their
criteria?
What difference does it make? - ANSWER-Rotterdam criteria includes milder forms
(non- hyperandrogenic) of PCOS which increases prevalence compared to Androgen
Excess Society criteria and may make comparison across studies difficult
What are 2 types of menstrual irregularities seen in women w/ PCOS? - ANSWER-
Oligomenorrhea
Amenorrhea
Define oligomenorrhea - ANSWER-- Nine or fewer menstrual cycles per year
- More than 38 days (~ 6 weeks) from start of menses to start of next menses
- Typically begins around onset of first menses (menarche) which may itself be delayed
define amenorrhea - ANSWER-- No menstrual cycles for three or more consecutive
months
What are irregular menses usually the result of? - ANSWER-anovulation (failed oocyte
production)
how does anovulation cause irregular menses? - ANSWER-- Ovulation is required to
form a corpus luteum which secretes progesterone
- Endometrial lining requires priming with progesterone to slough off in a predictable
fashion
What must you see on ultrasound to meet the rotterdam criteria of polycystic ovaries -
ANSWER-12 or more follicles 2-9 mm in diameter in each ovary or increased ovarian
volume
Are polycystic ovaries a common finding in women w/ PCOS? - ANSWER-yes,
extremely common
- 92% of patients with hirsutism
