PCOS & SIGNS EXAM QUESTIONS WITH
COMPLETE ANSWERS
Treating PCOS - ANSWER-- If no pregnancy is desired - birth control pills
- If pregnancy is desired - Clomid <-- Estrogen Modulator
- Metformin for Insulin resistance
Stein-Leventhal syndrome - ANSWER-PCOS
Pathiphysiology - ANSWER-abnormal GnRH secretion that causes increase in LH and
FSH
LH stimulates andrgoen production by the stimulation of theca cells
this increase in androgens causes male like features in women
PCOS and GnRH - ANSWER-insulin resistance in high BMI causes abnormal GnRH
pulsation***
this increases the LH/FSH ratio
Sx of PCOS - ANSWER-anovulation
hyper-androgenism
ovarian cysts
acne
hirsutism**
high BMI**
insulin resistance**
alopecia
infertility/subfertility
labs of PCOS - ANSWER-
GnRH receptor agonists - ANSWER-leuprolide
goserelin
nafarelin
GnRH agonist MOA - ANSWER-constant stimulation of the GnRH receptors will cause
desensitization of the GnRH receptor at the APG
this will stop APG from releasing FSH/LH secretion
Androgen-insensitivity syndrome causes GnRH due to inability of androgen to exert
negative-feedback at androgen receptors at the hypothalamus. - ANSWER-
, Menopause (which is physiologic), as well as any condition characterized by primary
hypogonadism or insufficiency (i.e., Turner, Klinefelter, premature ovarian failure, etc.,
which are all pathologic), will cause GnRH secretion due ¯ negative-feedback . -
ANSWER-"Primary" means the organ itself (i.e., the ovary or testis) is the reason for the
change in hormone secretion, whereas "central" means the hypothalamus or anterior
pituitary is the reason.
cause of hirsutism in PCOS - ANSWER-increase in LH
"abnormal GnRH pulsation"
LH and FSH levels in PCOS - ANSWER-LH is high
FSH is low
LH/FSH ratio is high
LH function - ANSWER-acts on the theca lutein cells
this makes androgens that will be converted by ovaries to make estrogen
FSH function - ANSWER-acts on the GC cells to make aromatase to make estrogen for
the ovaries
FSH/LH in PCOS - ANSWER-LH is released in higher amounts so more androgens are
made
FSH is lower so there is poor follcile development leading to lack of GD rupture and
anovulation
the follicle is retained within the ovary causing the formation of the ovarian cyst
high BMI and irregular periods - ANSWER-anovulation
anovulation and hirsutism - ANSWER-PCOS
Dx PCOS - ANSWER-US showing cysts BL
progesterone and estrogen on PCOS - ANSWER-no ovulation due to lack of FSH
means no estrogen or follicle rupture
no rupturing of the follicle will not form a CL and no progesterone
estrogen is deemed higher than progesterone because progesterone isnt made and
estrogen is low but high in comparison
unopposed estrogen means - ANSWER-increased risk of endometrial hyperplasia
COMPLETE ANSWERS
Treating PCOS - ANSWER-- If no pregnancy is desired - birth control pills
- If pregnancy is desired - Clomid <-- Estrogen Modulator
- Metformin for Insulin resistance
Stein-Leventhal syndrome - ANSWER-PCOS
Pathiphysiology - ANSWER-abnormal GnRH secretion that causes increase in LH and
FSH
LH stimulates andrgoen production by the stimulation of theca cells
this increase in androgens causes male like features in women
PCOS and GnRH - ANSWER-insulin resistance in high BMI causes abnormal GnRH
pulsation***
this increases the LH/FSH ratio
Sx of PCOS - ANSWER-anovulation
hyper-androgenism
ovarian cysts
acne
hirsutism**
high BMI**
insulin resistance**
alopecia
infertility/subfertility
labs of PCOS - ANSWER-
GnRH receptor agonists - ANSWER-leuprolide
goserelin
nafarelin
GnRH agonist MOA - ANSWER-constant stimulation of the GnRH receptors will cause
desensitization of the GnRH receptor at the APG
this will stop APG from releasing FSH/LH secretion
Androgen-insensitivity syndrome causes GnRH due to inability of androgen to exert
negative-feedback at androgen receptors at the hypothalamus. - ANSWER-
, Menopause (which is physiologic), as well as any condition characterized by primary
hypogonadism or insufficiency (i.e., Turner, Klinefelter, premature ovarian failure, etc.,
which are all pathologic), will cause GnRH secretion due ¯ negative-feedback . -
ANSWER-"Primary" means the organ itself (i.e., the ovary or testis) is the reason for the
change in hormone secretion, whereas "central" means the hypothalamus or anterior
pituitary is the reason.
cause of hirsutism in PCOS - ANSWER-increase in LH
"abnormal GnRH pulsation"
LH and FSH levels in PCOS - ANSWER-LH is high
FSH is low
LH/FSH ratio is high
LH function - ANSWER-acts on the theca lutein cells
this makes androgens that will be converted by ovaries to make estrogen
FSH function - ANSWER-acts on the GC cells to make aromatase to make estrogen for
the ovaries
FSH/LH in PCOS - ANSWER-LH is released in higher amounts so more androgens are
made
FSH is lower so there is poor follcile development leading to lack of GD rupture and
anovulation
the follicle is retained within the ovary causing the formation of the ovarian cyst
high BMI and irregular periods - ANSWER-anovulation
anovulation and hirsutism - ANSWER-PCOS
Dx PCOS - ANSWER-US showing cysts BL
progesterone and estrogen on PCOS - ANSWER-no ovulation due to lack of FSH
means no estrogen or follicle rupture
no rupturing of the follicle will not form a CL and no progesterone
estrogen is deemed higher than progesterone because progesterone isnt made and
estrogen is low but high in comparison
unopposed estrogen means - ANSWER-increased risk of endometrial hyperplasia
