Polycystic Ovarian Syndrome (PCOS) Exam Questions with Correct Answers

When a patient walks into your office with chronic anovulation and obesity, what should be a major concern? - ANSWER-Endometrial Hyperplasia in those with PCOS What is the most common hormonal disorder in reproductive age women? - ANSWER-PCOS Where is GnRH released from? - ANSWER-arcuate nucleus of the hypothalamus NOTE: PCOS fundamentally is an imbalance/dysfunction in ovulation, and therefore menstruation ----A woman will say that her menstruation is irregular, may occur every 40 days, or may not occur at all - ANSWER-... Describe the pathway by which the ovary releases estrogen and progesterone. - ANSWER-1) GnRH gets released from the arcuate nucleus of the hypothalamus 2) It goes to the Anterior Pituitary and signals to increase synthesis and release FSH and LH 3) FSH & LH go to the ovary to produce and release estrogen and progesterone The anterior pituitary relies on pulsatile input from GnRH...What are the effects of GnRH that gets released too fast? too slow? just right? - ANSWER-1. If GnRH frequency is TOO FAST, or continuous (e.g. GnRH agonist), FSH/LH levels rise initially then decrease ---This results in desensitization/downregulation of the pituitary 2. If GnRH frequency is TOO SLOW, there is insufficient FSH/LH to drive the ovaries and the woman won't ovulate at all 3. If GnRH frequency is JUST RIGHT, normal (regular and predictable) ovulatory cycles occur What is the hallmark finding of PCOS? - ANSWER-Menstrual dysfunction What structure is the main progesterone maker in the ovary? - ANSWER-Corpus Luteum The egg needs to get nutrients and be in just the right environment of hormones to hit second meiosis in order to ovulate. What provides nutrients to the egg? - ANSWER-Theca Cells and Granulosa Cells