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Review of Clinical Signs Review Questions

Signs of Hyperandrogenism in Women

Bernard M. Karnath, MD

Choose the single best answer to each question.

1. A 25-year-old woman presents for evaluation of irregular menstrual periods and increasing body hair. Menarche occurred at age 13 years, but she has never had regular periods. Physical examination reveals moderate hirsutism. The pelvic examination is normal. Laboratory studies include the following: dehydroepiandrosterone, 2800 ng/dL (normal, 130–980 ng/dL); luteinizing hormone (LH), 12 mIU/mL; follicle-stimulating hormone (FSH), 5 mIU/mL; 17-hydroxyprogesterone, 553 ng/dL (normal, 100–250 ng/dL); total testosterone, 110 ng/dL (normal, 6–86 ng/dL). What is this patient’s diagnosis?

  1. Asherman’s syndrome
  2. Cushing’s syndrome
  3. Nonclassic congenital adrenal hyperplasia (CAH)
  4. Polycystic ovary syndrome (PCOS)
  5. Turner’s syndrome
Click here to compare your answer.


Questions 2 and 3 refer to the following case:

A 27-year-old woman presents for evaluation of hirsutism. She reports gradual development of facial hair over the past 5 years. Menarche occurred at age 14 years but menses have been irregular. Her most recent menstrual period was 3 months ago. On physical examination, acne is noted on her face and terminal hair is seen on her upper lip and areola. The rest of the physical examination is normal. Laboratory studies include the following: total testosterone, 150 ng/dL (normal, 6–86 ng/dL); LH, 20 mIU/mL; FSH, 7 mIU/mL; 17-hydroxyprogesterone, 150 ng/dL (normal, 100–250 ng/dL); and fasting glucose, 126 mg/dL (normal, 70–110 mg/dL).

2. What is this patient’s most likely diagnosis?

  1. Asherman’s syndrome
  2. Cushing’s syndrome
  3. Nonclassic CAH
  4. PCOS
  5. Turner’s syndrome
Click here to compare your answer.


3. Two years later, the patient marries and desires pregnancy. Which of the following is the optimal agent for her condition?

  1. Clomiphene citrate
  2. Finasteride
  3. Flutamide
  4. Metformin
  5. Spironolactone
Click here to compare your answer.

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