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Obs and Gynae
PCOS
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Created by
Sosan Bajwa
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Cards (25)
What is the primary characteristic of polycystic ovary syndrome (PCOS)?
Hyperandrogenism
,
ovulation disorders
,
polycystic morphology
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What are common signs and symptoms of PCOS?
Oligomenorrhoea
,
hirsutism
, acne,
subfertility
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What investigations are used in the diagnosis of PCOS?
Hormonal assays
and
imaging techniques
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What is the definition of polycystic ovary syndrome (PCOS)?
Disorder characterised by:
Hyperandrogenism (
oligomenorrhoea
,
hirsutism
,
acne
)
Ovulation disorders
Polycystic ovarian morphology
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How common is PCOS among women of reproductive age?
Affects up to a
quarter
of women
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What is the aetiology of PCOS?
The precise aetiology remains undetermined
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What hormonal imbalances are implicated in PCOS?
Hyperandrogenism
, insulin resistance,
elevated LH
, raised
oestrogen
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What are the signs and symptoms of PCOS?
Oligomenorrhoea
Subfertility
Acne
Hirsutism
Obesity
Mood changes (depression, anxiety)
Male pattern baldness
Acanthosis nigricans
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What are the differential diagnoses for PCOS?
Menopause
Congenital adrenal hyperplasia (
CAH
)
Hyperprolactinaemia
Androgen-secreting tumours
Cushing's syndrome
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What characterizes menopause in differential diagnosis?
Cessation
of menstruation,
hot flashes
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What are the symptoms of congenital adrenal hyperplasia (CAH)?
Signs of
androgen
excess like hirsutism
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What symptoms are associated with hyperprolactinaemia?
Irregular periods,
galactorrhoea
,
infertility
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What characterizes Cushing's syndrome?
Weight gain
,
purple stretch marks
, easy
bruising
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What investigations are pivotal in diagnosing PCOS?
Clinical examination for
hyperandrogenism
Blood tests (
LH:FSH ratio
,
total testosterone
)
Fasting and oral glucose tolerance tests
Imaging (ultrasound for ovarian morphology)
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What does an increased LH:FSH ratio indicate in PCOS diagnosis?
Helps differentiate from
menopause
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What is the Rotterdam Diagnostic Criteria for PCOS?
At least
two of three criteria must be met
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What are the criteria for diagnosing PCOS according to the Rotterdam criteria?
Polycystic ovaries
(>
12
cysts or volume >
10 cm³
)
Oligo-/anovulation
Clinical or biochemical
hyperandrogenism
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What are the management strategies for PCOS?
Conservative
: Weight loss, exercise, education
Medical
(not planning pregnancy): Co-cyprindrol,
COCP
,
Metformin
Medical (wishing to conceive):
Clomiphene
, Metformin, Gonadotrophins
Surgical
(wishing to conceive):
Ovarian drilling
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What is the role of Metformin in PCOS management?
Regularises
menstruation
, reduces hirsutism,
acne
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What is the purpose of ovarian drilling in PCOS treatment?
Damages
hormone-producing cells
of the ovary
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What are the complications associated with PCOS?
Infertility
Metabolic syndrome
and dyslipidaemia
Type 2 diabetes
Cardiovascular disease
Hypertension
Obstructive sleep apnoea
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How does PCOS affect the risk of Type 2 diabetes?
Increases risk by approximately
two fold
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What is the relationship between PCOS and cardiovascular disease?
Likely a consequence of
metabolic complications
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What is the risk of hypertension in women with PCOS?
Greater risk in
premenopausal
women
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What causes obstructive sleep apnoea in PCOS patients?
Result of
obesity
and
metabolic
changes
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