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icecool
Forum Senior Topics: 22 Posts: 113 |
A 32-yr old woman has a 3 yr his of oligomenorrhea that has progressed to amenorrhea during the past yr. She has observed loss of breast fullness, reduced hip measurements, acne, increased body hair, and deepening of her voice. P/E reveals frontal balding, clitoral hypertrophy, and a male escutcheon. Urinary free cortisol and DHEAS are normal. Her plasma testerone level is 6 ng/ml. The most likely diagnosis is: a. Cushing's syn b. Arrhenoblastoma c. Polycytic ovary syndrome d. Granulosa-theca cell tumor
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ELM
| Forum Guru Topics: 28 Posts: 932
C.
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icecool
| Forum Senior Topics: 22 Posts: 113
try again?
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loreal
| Forum Junior Topics: 5 Posts: 53
A
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loreal
| Forum Junior Topics: 5 Posts: 53
A
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loreal
| Forum Junior Topics: 5 Posts: 53
A
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icecool
| Forum Senior Topics: 22 Posts: 113
answer is b. key: differentiation of hirsutism and virilization. a and c are the causes of hirsutism.
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Hamidi
| Forum Guru Topics: 46 Posts: 471
I did not have any clue wat arrhenoblastoma is. Found it on the internet.I thought I shud share just incase someone else is wondering (like me) wat is it? :?: Alternative names Stromal tumor; Gonadal stromal tumor; Sex cord tumor; Androblastoma Definition Arrhenoblastoma of the ovary is an ovarian tumor that secretes testosterone. Causes, incidence, and risk factors This is a rare tumor that accounts for less than 0.5% of all ovarian tumors. These tumors are found in women of all age groups, but are most common in young women. Symptoms This tumor secretes male hormones which causes secondary sex changes in women including: deepening of the voice increased facial and body hair increased size of the clitoris male pattern baldness Signs and tests ultrasound of the ovaries CT scan of pelvis and abdomen to look for tumor spread blood tests to check levels of hormones which may be secreted by the tumor Treatment Surgery is the main treatment. If the cancer has spread, chemotherapy or radiation therapy should be considered
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icecool
| Forum Senior Topics: 22 Posts: 113
it is an ovarian tumor, but did not read this one in step1. Anyway, this point is mentioned in both Secrets and Pretest, so it is worth to know.
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icecool
| Forum Senior Topics: 22 Posts: 113
good job Hamidi, thanks!
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ELM
| Forum Guru Topics: 28 Posts: 932
Very nice Hamid! :lol: Keep going!
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SA
| Forum Senior Topics: 21 Posts: 190
"icecool" wrote: A 32-yr old woman has a 3 yr his of oligomenorrhea that has progressed to amenorrhea during the past yr. She has observed loss of breast fullness, reduced hip measurements, acne, increased body hair, and deepening of her voice. P/E reveals frontal balding, clitoral hypertrophy, and a male escutcheon. Urinary free cortisol and DHEAS are normal. Her plasma testerone level is 6 ng/ml. The most likely diagnosis is: a. Cushing's syn b. Arrhenoblastoma c. Polycytic ovary syndrome d. Granulosa-theca cell tumor Nice work by Hamidi but I am wondering the level of testerone level is 6 ng/ml I think it is very low for this tumor what I remeber from my clinical practice. icecool can you check it again for me :?: Thanks
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indlaxman
| Forum Elite Topics: 68 Posts: 159
good job hamidi 
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icecool
| Forum Senior Topics: 22 Posts: 113
To SA, The q is from Pretest, it is indeed 6 ng/ml (normal: 0.2~point eight, sorry I have a problem with "8" key!!). What is your exp? thanks!
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loreal
| Forum Junior Topics: 5 Posts: 53
HI well done hamidi i did look for choice b but was confused cuz i was not getting proper info thanks for ur info
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Hamidi
| Forum Guru Topics: 46 Posts: 471
Welcome.I knew it wasn't A,C &D but did not know wat exactly is B.All I did was search on google.Life is much easier with internet.
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SA
| Forum Senior Topics: 21 Posts: 190
"icecool" wrote: To SA, The q is from Pretest, it is indeed 6 ng/ml (normal: 0.2~point eight, sorry I have a problem with "8" key!!). What is your exp? thanks! it should be something in 100s please check it again I am also checking and will post the refrence if I find one.
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Hamidi
| Forum Guru Topics: 46 Posts: 471
I think it is free testosteron leve(n 0.7-3.6pg/ml in females)not the testosterone levelwhich is6-86 ng/dl in females.just a guess
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icecool
| Forum Senior Topics: 22 Posts: 113
Hi, SA, The original ref is "Fauci, 14/e, p20" Pretest-Medicine. The following cited is from a web article: "If the serum testosterone is greater than 200 ng/dL, or free testosterone is greater than 40ng/dL, or the androstenedione is greater than 1000 ng/dL, pelvic exam and Ultrasound may be performed to look for ovarian cancer. If the Ultrasound is negative, a CT scan of the adrenal glands is performed to look for adrenal cancer." I think this is in agreement with the q (> 2 ng/ml --->consider ovarian cancer). Many articles did not give the exact value, but if I found good ones, I will post them later. Good work everybody, we are doing research here! Another point I would add is: signs are the key for making diagnosis of arrhenoblastoma. May be we can ask a q this way: what signs found in this pt can also be seen in a pt with hirsutism?
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loreal
| Forum Junior Topics: 5 Posts: 53
good info guys keep it up :lol:
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