PCOs

Question 1

SBA

Porportion of circulating testosterone in the female produced by the ovaries?

Answer 1

25%

Question 2

Androgens produced by the ovaries

Answer 2

• 25% of circulating testosterone
• 20% of dehydroepiandrosterone
• 50% of androstendione

Question 3

Incidence of PCOs

Answer 3

10-15% of females

Question 4

Endocrinology of PCOs

Answer 4

1. Inc or normal androgens
2. Inc or normal LH (inc in 40%)
3. Normal FSH
4. Inc or normal fasting insulin
5. Inc or normal E2
6. Inc AMH

Question 5

Do we use LH/FSH ratio for dignosis of PCO

Answer 5

No
Only rotterdam crietria

Question 6

How to doagnose PCOs in adolescents

Answer 6

Must have all the criteria 3/3

Question 7

Which is worse buttock fat or belly fat

Answer 7

Belly fat as it is responsible for insulin resistance

Question 8

Lifelong consequences of PCOS

Answer 8

1.DM : GDM OR TYPE II
2. Sleep apnea: more in obese
3. CVD
4. Depression and anxiety
5. Hyperplasia and endometrial cancer

Question 9

How to reduce risks of PCOs

Answer 9

1. Weight reduction and life style modification
2. Insulin sensitizers: metformin
3. Weight reduction drugs: orlistat
4. Lap ovarian drilling
5. Bariatric surgery

Question 10

Percent of patients with pcos that develop metabolic disease

Answer 10

33%

Question 11

Dietary goals in obese woman with PCOS

Answer 11

1. Carbohydrates with low glycemic index
2. Fibers
3. Proteins
4. More omega 3 ( not omega 6)

Question 12

Pco management

Answer 12

• Withdrawal bleeding at least every 3 months.
• In amenorrheic women : US to measure ET every 6-12 M, if greater than 10 mm: artificially induced bleed, followed by repeat us and end biopsy if the end has not been shed. Or mirena.

Question 13

Percent of ovulation with CC
AND WHAT PERCENT WILL BE PREGANANT

Answer 13

ovulation 70-85%

Pregnancy: 60-70%

Question 14

How to perfrom ovarian drilling

Answer 14

4 drillings per ovary
For 4 seconds
At 40 watt

Question 15

Dose of gonadotropins

Answer 15

25-50 iu of rFSH or hMG for 2w
If no respomse
Inc 50% of initial dose for 1 w till max 35 days

Once dominant follicle 17 mm -> hcg 5000Iu

Question 16

Normal testosterone level in females

Answer 16

0.5 - 2.5 nmol/l