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Gynaecology & Obstetrics PCOD, hirsutism and galactorrhea cc8c3c17

Which of the following is most likely the diagnosis of 27years old obese woman presenting with Oligomenorrhea, infeility and hirsutism

A
Polycystic ovaries
B
Endometriosis
C
Pelvic inflammatory disease
D
Turner's syndrome
High-Yield Explanation
PCOD ( Stein leventhal syndrome) Basic pathology of PCOD is excessive androgen synthesis leads to Leads to hirsutism Peripheral aromatisation Alters lipid profile LDL /HDL Because of peripheral aromatisation causes conversation to oestrogen leading to Increased LH ( oestrogen has positive feedback on LH) LH is tonically elevated throughout the cycle This causes stimulation of the a cells leading to the a cell hyperophy And excessive androgen production ( hirsutism , infeility, amenorrhea) And drecreased FSH ( oestrogen has negative feedback on FSH) Leading to anovulation and decrease progesterone levels leading to Oligomenorrhea These changes may affect endometrium leading to endometrial hyperplasia in fuher causing endometrial cancer Due to altreation of lipid profile may lead to fuher hea diseases in future Ref Shaw 15/e pg 371

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