HIRSUTISM AND VIRILISM Flashcards Preview

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Flashcards in HIRSUTISM AND VIRILISM Deck (13):
1

What is hirsutism?

Excessive hairiness in a woman in those parts in which hair growth is normally either absent or minimal. Eg beard or chest hair.

2

What are the features of hirsutism with virilism in women?

Excessive hair growth

Clitoral hypertrophy

Breast atrophy

Deepening of voice

Male pattern balding

3

What percentage of healthy women are said to have a degree of hirsutism with or without virilism?

10%

4

Are virilism and hirsutism independent (ie one does not necessarily come with the other)?

Hirsutism can occur without virilism, however, virilism does not tend to occur without hirsutism (apart from in neonates)

5

What are the causes of hirsutism?

Idiopathic

Adrenal:
Congenital adrenal hyperplasia
Cushing's syndrome

Ovarian:
PCOS

Iatrogenic:
Androgens
Anabolic steroids
Danazol
Norethisterone
Phenytoin

6

What are the causes of virilism with hirsutism?

Never idiopathic

Adrenal:
Congenital adrenal hyperplasia
Cushing's syndrome

Ovarian:
Tumours
Arrhenoblastomas
Hiler cells
Pregnancy luteomas

Iatrogenic:
Androgens
Anabolic steroids
Danazol

7

What is the most common cause of hirsutism?

PCOS

8

What are the features seen on examination of a patient with PCOS?

Obesity

Acanthosis nigricans

Hirsutism

Acne

9

What are the features seen on examination a patient with congenital adrenal hyperplasia?

Obesity

Hirsutism/virilism

Ambiguous external genitalia in severe cases

10

What are the features seen on examination of a patient with Cushing's syndrome?

Hirsutism/virilism

Central obesity

Peripheral muscle atrophy

Hypertension

Striae

11

What are the features seen on examination of a patient with an androgen producing tumour?

Hirsutism/virilism

Very little in terms of systemic upset

Often no masses felt

12

How can we treat idiopathic hirsutism?

Bleaching

Electrolysis

Psychological support

13

How do you treat hirsutism associated with PCOS?

Encourage weight loss

Medical treatment is a combination of Ethinyloestradiol and an anti-androgen such as cyproterone acetate

Metformin has also been shown to help with all features of PCOS, as recent evidence insulin resistance is a causative factor rather than just a complication.