00:01 Let's go on to another case. 00:03 Here we have a 34 year old woman who is seen for recent hirsutism of the face, chest and abdomen. 00:09 Hair growth has progressed over the last few years. 00:12 Menstrual cycles have become irregular over the same time course. 00:17 Medical history is otherwise unremarkable and she doesn't take any medications. 00:22 On physical exam, her blood pressure is 138/90 and the remainder of the vital signs are normal. 00:28 Her BMI is 26. 00:31 On exam, she has acne, dark terminal hairs appear on the face, chest and abdomen. 00:37 The patient's hair is thinning on the top of her head. 00:41 The remainder of the physical exam is noncontributory. 00:44 On lab evaluation, her estradiol level is 68 picograms per ml, her FSH is 12 mU/ml and her beta HCG is negative. 00:55 She has a normal prolactin level and a testosterone level of 120 ng/dL, with a normal TSH. 01:03 What is the best diagnosis for this case? So looking at the patient's history, she has hirsutism, altered menses, increased blood pressure, slightly elevated body mass index and an elevated testosterone. 01:18 These all suggest hyperandrogenism or abnormal masculine characteristics that develop in a female. 01:27 The best diagnosis is polycystic ovary syndrome, this is the most common cause in most women who present with hirsutism. 01:36 Women with chronic hirsutism and menstrual cycles every 25 to 35 days mostly have idiopathic hirsutism or polycystic ovarian syndrome. 01:45 This accounts for 95% of cases.
The lecture Reproductive Case: 34-year-old Woman with Hirsutism by Michael Lazarus, MD is from the course Reproductive Endocrine Disorders.
What is the best diagnosis in the case described below? A 34-year-old woman presents with recent hirsutism of the face, chest, and abdomen. Over the last few years, the hair growth has progressed, and her menstrual cycles have become irregular. She has an otherwise unremarkable medical history and takes no medications. Physical examination: Blood pressure of 138/90 mm Hg and BMI of 26 kg/m2. Patient has acne; dark terminal hair on the face, chest, and abdomen; and hair thinning on the top of the head. Laboratory test results: Estradiol level of 68 pg/mL, FSH level 12 mU/mL, serum hCG result is negative, normal PRL level, testosterone level of 120 ng/dL, and normal TSH level.
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