Case Study PCOS Exam Questions and Answers

Case + Initial symptoms (why she was brought in) - ANSWER-15 year old girl. Obesity and amenorrhea. Metabolic Syndrome - ANSWER-Cluster of increased BP, sugar level, waist body fat, cholesterol levels. Increases the risk of heart disease, stroke, and diabetes. Family's health history - ANSWER-Parents normal weight but with metabolic syndrome. Two female siblings healthy and normal weight. Mother had gestational diabetes mellitus during pregnancy. Patient's Health History - ANSWER-Patient started weight gain from 8 years old. Weight increased from 10th to 70th (obese) percentile. Menarche occured at the age of 14 but she developed secondary amenorrhea afterwards. Hirsuite and acanthosis nigricans - ANSWER-hair growth in a male pattern on a woman with mild acne. No acanthosis nigricans which is brown/black areas on neck and skin folds. What is acanthosis nigricans associated with? - ANSWER-Associated with obesity, PCOS, diabetes (insulin), excess androgens, Cushing's disease. Basal TSH, thryoxine, urinary cortisol. What does this rule out? - ANSWER-These were all normal. This rules out other diseases that cause menstrual irregularity and hyperandrogenism. Serum transaminases and creatine levels. What does this rule out? - ANSWER-All normal. This rules out liver disease. Usually associated with PCOS or insulin resistance and obesity. gonadotrophic hormone and androgen levels. What does this rule out/imply? - ANSWER-FSH, estrogen, estradiol levels were normal. This excludes primary ovarian failure (impaired response of gonads to gonadotrophins). 17-OH progesterone and prolactin normal which includes hyperprolactinemia and late-onset congenital adrenal hyperplasia. T and LH were elevated. Fasting blood glucose levels. What does this imply? - ANSWER-Elevated fasting glucose levels and abnormal glucose tolerance test. Impaired glucose tolerance present, suggests diabetes type 2 presence. Hyperinsulinemia - ANSWER-Had severe excess of insulin.