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1、Polycysticovariansyndrome吉林市中心医院妇产科安晓汾JilinCentralHospitalobstetricsandGynecologyCasestudy _clinicaldialogueCasesummaryA23-year-oldmorbidlyobese,gravida0,whopresentedtothegynecologyofficeforevaluationofirregularmensessincemenarche.Thepatientstatedthatonaverage,shehas1pe
2、riodevery5-6months.Whensheisonherperiod,shebleedsveryheavily,passinglargeclotswithalotofabdominalcramping.Shealsocomplainedaboutexcessivefacialhair,whichrequireshertoshaveatleastonceseveraldays,andalotofhaironherabdomenanarmsaswell.Shedeniedanychangeinhervoiceorincrease
3、inthesizeofhermuscles.Shehasbeenmorbidlyobesesinceshewasayoungteenager.Shedeniedanyheadaches,blurredvision,ordischargesfromhernipples.Shealsodeniedanyhyper-orhypothyroidismsymptoms.Shehasneverhadanysurgeryinthepast.Shewasunabletoconceivedespiteoneyearofactivelytrying.Sh
4、eisnotcurrentlytakinganymedicationandhasneverusedanyformofcontraception.8.Haveyounoticedanychangesonyourvoiceorexcessivehairloss??----Idong’tthinkso.9.Haveyouanyproblemswithyourthyroidgland?----NotthatIknowof.10.Haveyoueverexperiencedsomethinglikedryskinfatigue,moodswin
5、gsoranydepression?---No,notreally11.whataboutheadaches,visionchange,ordischargefromyournipples?--no.12.Well,let’stalkalittlebitaboutyourweightchangeovertime?----Ihavebeenoverweightformostofmylife.IwasontheheavysidesinceIwasakidandIgainedanother40to50poundsaftercollege(1
6、pounds=0.45359237kg).13.Haveyoudoneanythingtocontrolyourweight??----Iamtryingtoexciseandeathealthy,butIhavn’thadanytypeofsurgeries.14.Isthereanythingelsethatyouwouldliketotalkabout?----Notfornow..15.Verygood,next,wewuldneedtodoaphysicalexaminationincludingpelvic----Alri
7、ght.PhysicalexaminationincludingpelvicexamShewasclearlyhirsute(Ferriman-Galloweyscoreof10),especiallyinthechinandmid-abdominalregion.Herbodymassindex(BMI)was31.Herpelvicexaminationwasunremarkable,includingnoevidenceforclitoromegaly,butitwasverydifficulttoappreciateherut
8、erusandadnexasecondarytopatient’sbodyhabitus.Therestofherphysicalexaminationwasunremarkable.ATVUS(transvaginal
