Let’s review your knowledge on Polycystic Ovary Syndrome (PCOS):
PCOS presents as a patient having at least two of the following three features. Select the three features that are presented with PCOS. Select all that apply.
A. Elevated levels of androgens such as testosterone
B. Acute abdominal pain with nausea and vomiting
C. Irregular ovulation
D. Appearance of polycystic ovaries on ultrasound
Rationale: If you selected elevated levels of androgens, irregular ovulation, and appearance of polycystic ovaries on ultrasound you are correct. If the patient has two of these three symptoms presenting, it will be noted as PCOS. It is possible for a patient to have PCOS without the presence of polycystic ovaries on ultrasound. Answer B is incorrect because this is a symptom of Pelvic Inflammatory Disease.
True or False. PCOS remains one of the most common endocrine disturbances affecting women,especially young women, and is a leading cause of infertility in the United States.
Rationale: The answer is True. PCOS is associated with metabolic dysfunction, including dyslipidemia, insulin resistance and obesity among women.
Select the appropriate clinical manifestations you might see in a patient with PCOS.
A. excessive vaginal discharge, decreased prolactin, and infertility
B. Decreased insulin, dysmenorrhea and Constipation
C. Obesity, acne, infertility, amenorrhea, hirsutism
D. Infertility, Hypertension, decreased insulin, and normal BMI
Rationale: The correct answer is C with the patient presenting with obesity, acne, infertility, amenorrhea, and hirsutism (abnormally increased body hair). The others are incorrect due to presenting as the opposite symptoms you would usually be seeing in PCOS. Such as in answer A you will not see Anorexia or decreased prolactin, it would be increased prolactin. In answer B dysmenorrhea (pain during menstruation) is usually seen in Endometriosis and not PCOS and constipation is not a normal symptom for PCOS. Answer D is incorrect due to the hypertension, decreased insulin and normal BMI noted since in PCOS it is present more in the obesity population. The patient will present with obesity 41% of the time, and have increased insulin.
True or false. A surgical view of a polycystic ovary will present as an enlarged, irritated, rough capsule?
Rationale: False. A polycystic ovary will present as a smooth pearly white capsule.
Diagnosis of PCOS can be made based off of what results?
A. Glucose within normal limits
B. Increased serum androgens and increased LH with normal FSH
C. Biopsy is necessary to confirm diagnosis
D. Decreased levels of LH and prolactin
Rationale: The correct answer is B. Answer C pertains to endometriosis where a biopsy should be taken to confirm diagnosis. Answer A and D are incorrect due to it being the opposite of the levels of the PCOS.