Women's Gynecologic Health REVIEW EXAM 2- CH 9,13,14,15 25-32, (Schuiling & Likis, 2021) - FALL 2022

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HYPERANDROGENISM - ANSWER Associated w/ Polycystic Ovary Syndrome (PCOS); Degrees of ovulatory dysfunction; Oligo-anovulation; Infertility result of anovulation; Endocrinopathy; Occurs in 6-15% of a... ll women; 70% w/ Hirsutism, Acne, Androgenic Alopecia; Obesity, insulin resistance, dyslipidemia of metabolic syndrome; risk for CV disease & DM; Increased risk for adverse health outcomes (Endometrial CA; T2DM) OVARIES - ANSWER Source of increased Testosterone & Androstenedione; Source of increased androgen production; key to determining cause of Hyperandrogenism ANDROGEN PRODUCTION - ANSWER ovaries/adrenal glands HYPERANDROGENISM CYCLE - ANSWER Elevated Androgens & Insulin suppress SHBG synthesis; results in increase in free testosterone; exacerbates insulin resistance HIRSUTISM - ANSWER Excessive terminal hair growth in women; occurs in anatomic areas where hair follicles are most androgen sensitive; not all women with PCOS have hirsutism ALOPECIA - ANSWER Prolonged exposure to circulating androgens may cause hair loss ACNE - ANSWER Presents in 20s; alerts clinician to possibility of Hyperandrogenemia VIRILIZATION - ANSWER Clitoral hypertrophy, severe hirsutism, deepening voice, increased muscle mass, breast atrophy, male pattern baldness POLYCYSTIC OVARIES SYNDROME (PCOS) - ANSWER Oligo- or anovulation, Clinical and/or biochemical signs of Hyperandrogenism, Polycystic Ovaries, Exclusion of other Androgen Excess or related disorders; Associated w/ classic ovarian morphology; ½ of Pts. w/ PCOS = OBESE; Obesity increases risk for developing PCOS: Increased peripheral aromatization of androgens; Decreased levels of hepatic SHBG; Insulin resistance; Increases menstrual dysfunction/infertility; 50-70% w/PCOS have Insulin Resistance; Rates of Depressive Disorders, Anxiety Disorders, Binge-eating = higher in Women with POCS; Also 3x Increased risk of developing Endometrial CA. DYSLIPIDEMIA - ANSWER Found in women w/ PCOS; Vulvar Dermatoses - ANSWER Dermatoses can appear on vulva; Physical SX's; w/ psychological consequences; Women w/ Chronic Dermatoses may benefit from joining support groups; SX's: pruritus, pain, burning, bleeding, vaginal discharge; Definitive Diagnostic: BX; Irritant Contact Dermatitis (ICD); Allergic Contact Dermatitis (ACD); SX's: burning, pruritus, pain Lichen Sclerosus (LS) - ANSWER Benign, chronic, progressive disease of skin; SX's: inflammation, epithelial thinning, distinctive dermal changes; Figure-8 formation surrounds vulva and perianal area Lichen Planus (LP) - ANSWER Inflam'ty condition of scalp, skin, nails, mucous membranes; Usually perimenopausal or postmenopausal; SX's: Vaginal discharge, vulvar pruritus, vulvar pain/ burning, vaginal soreness, dyspareunia, postcoital bleeding; Classic LP: affects vulva; Hypertrophic LP: affects perineum; perianal area; Erosive LP: affects vulva & vagina Lichen Simplex Chronicus (LSC) - ANSWER Localized variant of atopic dermatitis; HX: Allergies/Asthma; result fr. Vulvar disorder that causes pruritus; SX: itch-scratch-itch cycle Psoriasis - ANSWER Chronic, immune-mediated, genetic disease; manifests in skin & joints; SX's: papules or plaques covered with silvery-white scales; Vulvar form: erythema common; scaling finer CERVICAL POLYPS - ANSWER Occur in up to 10% of women; very rarely malignant; Polyps w/vascular congestion appear moist, red, glandular; Polyp w/ atypical appearance needs BX (necrosis, contact bleeding, change in color); Bothersome atypical polyps should be removed ENDOMETRIAL POLYPS - ANSWER Hyperplastic overgrowth of endometrial glandular & stromal cells; vascular core; Incidence: 7-35% of women; often Asymptomatic; common cause of abnormal vag. bleed [Show More]

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