NURS 5333 Test Questions with Accurate
Solutions
PCOS labs : Testosterone - ANSWER Prefer to order Free testosterone level instead
of Total testosterone (avoid)
PCOS level typically range from 2-150
If over 200, suspect a virilizing tumor
Draw before starting any type of hormonal meds
If pt has signs of PCOS and normal testosterone, REDRAW test at 8 AM (best time
to draw the free testosterone level)
DHEA-S precurser - ANSWER -Coming from adrenal
glands -Helps detect adrenal hyperadrogenism
-Very very elevated. Commonly elevated in
PCOS -Levels above 700 suggest Adrenal Tumor
TSH - ANSWER obesity may be the reason why the TSH is elevated not vice versa
But it is still routinely ordered to check that there is no severe hypothyroidism
Hemoglobin A1C/OGTT - ANSWER Because pts are at risk for diabetes we want to
order -Most providers do both the hemoglobin A1C -Oral glucose tolerance test
, -GTT is the preferred test
-2 hr GTT yearly
lipids - ANSWER -Determine what their future cardiovascular risk
is Commonly see
-Elevated Triglycerides ( adolescent normal: @100 not 150mark as adults, the lower
the better)
-Decreased HDL
- Elevated LDL
Should an Insulin level be ordered? - ANSWER - Hyperinsulinemia is common in
healthy adolescent (insulin is a growth factor)
- You probably seen Type 1 pts need increased insulin doses due to INSULIN SENSITIVITY
during these ages 12-13 yo
- Leads to increased insulin levels
- Most providers do not draw insulin levels between 12-16 because of this
Once PCOS confirmed: Metabolic Syndrome - ANSWER -Central obesity defined as
waist less than 35 inches
- Asian women: 28 inches
- Serum triglycerides greater than 150mg/dL
- Serum HDL conct. less than 50 mg/dL in women
- Systemic HTN greater than 130/85 mmHg
- Fasting plasma glucose level greater than 100mg/dL
Management - ANSWER - Start w/
diet/exercise - High insulin levels = hunger
Solutions
PCOS labs : Testosterone - ANSWER Prefer to order Free testosterone level instead
of Total testosterone (avoid)
PCOS level typically range from 2-150
If over 200, suspect a virilizing tumor
Draw before starting any type of hormonal meds
If pt has signs of PCOS and normal testosterone, REDRAW test at 8 AM (best time
to draw the free testosterone level)
DHEA-S precurser - ANSWER -Coming from adrenal
glands -Helps detect adrenal hyperadrogenism
-Very very elevated. Commonly elevated in
PCOS -Levels above 700 suggest Adrenal Tumor
TSH - ANSWER obesity may be the reason why the TSH is elevated not vice versa
But it is still routinely ordered to check that there is no severe hypothyroidism
Hemoglobin A1C/OGTT - ANSWER Because pts are at risk for diabetes we want to
order -Most providers do both the hemoglobin A1C -Oral glucose tolerance test
, -GTT is the preferred test
-2 hr GTT yearly
lipids - ANSWER -Determine what their future cardiovascular risk
is Commonly see
-Elevated Triglycerides ( adolescent normal: @100 not 150mark as adults, the lower
the better)
-Decreased HDL
- Elevated LDL
Should an Insulin level be ordered? - ANSWER - Hyperinsulinemia is common in
healthy adolescent (insulin is a growth factor)
- You probably seen Type 1 pts need increased insulin doses due to INSULIN SENSITIVITY
during these ages 12-13 yo
- Leads to increased insulin levels
- Most providers do not draw insulin levels between 12-16 because of this
Once PCOS confirmed: Metabolic Syndrome - ANSWER -Central obesity defined as
waist less than 35 inches
- Asian women: 28 inches
- Serum triglycerides greater than 150mg/dL
- Serum HDL conct. less than 50 mg/dL in women
- Systemic HTN greater than 130/85 mmHg
- Fasting plasma glucose level greater than 100mg/dL
Management - ANSWER - Start w/
diet/exercise - High insulin levels = hunger
