POLYCYSTIC OVARIAN SYNDROME
(PCOS) EXAM QUESTIONS WITH
CORRECT ANSWERS
What 4 things must be ruled out to confirm absence of other endocrine disorders for
PCOS? - ANSWER-1. Nonclassical adrenal hyperplasia
---This is a very serious condition of the newborn
---It causes salt wasting that can be fatal
2. Androgen-secreting tumors
---Making too much testosterone and shutting off cycles
---This is very unusual
3. Hyperprolactinemia
---Prolactin is a very ubiquitous hormone
---It has effect on osmolarity and secretion of milk from breasts
---This can mimic PCOS
4. Thyroid dysfunction
---Hypothyroidism, if corrected, can mask PCOS
T/F Women with PCOS have abnormal reproductive organs. Explain. - ANSWER-
FALSE - they are normal
-No abnormal uteruses, fallopian tubes, or eggs
**PCOS is a problem with the brain and secretion of gonadotropins
T/F Surgery is often required to remove the cysts found in PCOS. - ANSWER-FALSE
In women with PCOS, what are the characteristic changes that occur to the ovary? -
ANSWER--Surface area is doubled, and the ovaries are large
-The same number of primordial follicles are present, however, the number of growing
and atretic follicles is doubled
-Each ovary may contain 20-100 follicles
-Thickness of tunica is increased by 50%
-Increased stroma is due to hyperplasia of thecal cells and increased formation
subsequent to excess follicle maturation and atresia
What do cysts develop from? - ANSWER--Women with PCOS do not usually produce a
MATURE egg on their own
1. The woman who still menstruates on her own is still probably having some form of
ovulation, though not regularly
, 2. She may ovulate every once in a while and the egg will be healthy if she is young, but
this ovulation is not reproducible
ii. As a result, the normal ovulatory process is not completed
***PARTIALLY DEVELOPED FOLLICLE BECOMES A CYST
Acne and hirsutism occur mainly due to what diagnostic criteria of PCOS? - ANSWER-
Excess Androgens
What is HIRSUTISM? - ANSWER-Occurs with increased ANDROGEN exposure.
It is the expression of hair in the midline of the body.
*It can include a mustache, hair on the chin, between the breasts, belly button, and
heavy distribution in the truncal area. NOT hair on sideburns, arms, legs.
What role does obesity play in PCOS? - ANSWER-i. About 50% of women with PCO
are obese
ii. With obesity comes the problems of menstrual irregularity and insulin secretion
iii. Obesity enhances abnormal estrogen and androgen production
Describe the alterations to hormones in PCOS. - ANSWER-1) Increased LH (luteinizing
hormone, from the anterior pituitary gland). This is the culprit. LH drives the production
of androgens in the ovary. If a woman has a tonically high level of LH from the pituitary,
that's the fundamental problem of PCOS
*This won't allow the egg to produce
2) Constant estradiol exposure
3) Minimal progesterone secretion- Estrogen can't get high enough to cause an LH
surge in order to get true ovulation and progesterone
4) Increased testosterone from decreased SHBG (sex hormone binding globulin).
Decreased SHBG allows for more free testosterone
5) Increased free estradiol and testosterone
6) Increased insulin
7) Decreased IGFBP-I
8) Increased IGF-I within the ovary
What is GLYCODELIN? - ANSWER-a biomarker of endometrial function, and low
circulating IGFBP-1.
(PCOS) EXAM QUESTIONS WITH
CORRECT ANSWERS
What 4 things must be ruled out to confirm absence of other endocrine disorders for
PCOS? - ANSWER-1. Nonclassical adrenal hyperplasia
---This is a very serious condition of the newborn
---It causes salt wasting that can be fatal
2. Androgen-secreting tumors
---Making too much testosterone and shutting off cycles
---This is very unusual
3. Hyperprolactinemia
---Prolactin is a very ubiquitous hormone
---It has effect on osmolarity and secretion of milk from breasts
---This can mimic PCOS
4. Thyroid dysfunction
---Hypothyroidism, if corrected, can mask PCOS
T/F Women with PCOS have abnormal reproductive organs. Explain. - ANSWER-
FALSE - they are normal
-No abnormal uteruses, fallopian tubes, or eggs
**PCOS is a problem with the brain and secretion of gonadotropins
T/F Surgery is often required to remove the cysts found in PCOS. - ANSWER-FALSE
In women with PCOS, what are the characteristic changes that occur to the ovary? -
ANSWER--Surface area is doubled, and the ovaries are large
-The same number of primordial follicles are present, however, the number of growing
and atretic follicles is doubled
-Each ovary may contain 20-100 follicles
-Thickness of tunica is increased by 50%
-Increased stroma is due to hyperplasia of thecal cells and increased formation
subsequent to excess follicle maturation and atresia
What do cysts develop from? - ANSWER--Women with PCOS do not usually produce a
MATURE egg on their own
1. The woman who still menstruates on her own is still probably having some form of
ovulation, though not regularly
, 2. She may ovulate every once in a while and the egg will be healthy if she is young, but
this ovulation is not reproducible
ii. As a result, the normal ovulatory process is not completed
***PARTIALLY DEVELOPED FOLLICLE BECOMES A CYST
Acne and hirsutism occur mainly due to what diagnostic criteria of PCOS? - ANSWER-
Excess Androgens
What is HIRSUTISM? - ANSWER-Occurs with increased ANDROGEN exposure.
It is the expression of hair in the midline of the body.
*It can include a mustache, hair on the chin, between the breasts, belly button, and
heavy distribution in the truncal area. NOT hair on sideburns, arms, legs.
What role does obesity play in PCOS? - ANSWER-i. About 50% of women with PCO
are obese
ii. With obesity comes the problems of menstrual irregularity and insulin secretion
iii. Obesity enhances abnormal estrogen and androgen production
Describe the alterations to hormones in PCOS. - ANSWER-1) Increased LH (luteinizing
hormone, from the anterior pituitary gland). This is the culprit. LH drives the production
of androgens in the ovary. If a woman has a tonically high level of LH from the pituitary,
that's the fundamental problem of PCOS
*This won't allow the egg to produce
2) Constant estradiol exposure
3) Minimal progesterone secretion- Estrogen can't get high enough to cause an LH
surge in order to get true ovulation and progesterone
4) Increased testosterone from decreased SHBG (sex hormone binding globulin).
Decreased SHBG allows for more free testosterone
5) Increased free estradiol and testosterone
6) Increased insulin
7) Decreased IGFBP-I
8) Increased IGF-I within the ovary
What is GLYCODELIN? - ANSWER-a biomarker of endometrial function, and low
circulating IGFBP-1.
