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Hirsutism

  • Common ddx

    • PCOS (obese, irregular menses)
    • Cushing's (moon face, abdominal striae, buffalo hump, steroid usage)
    • drugs
  • Serious ddx

    • pituitary tumor (visual defects), adrenal tumor (abdominal/flank mass), ovarian tumors
  • Labs

    • testosterone
    • cortisol
    • prolactin, MRI if suspect pituitary tumor
    • ultrasound if suspect ovarian tumor
    • sodium level, karyotype if suspect CAH
  • Onc ddx

    • pituitary adenoma, Cushing's disease, adrenal tumor
  • Ovarian tumor ddx

    • granulosa cell tumor, sertoli-leydig cell tumor
  • Drugs ddx

    • steroids, danazol, testosterone
  • Other

    • anorexia (fine, laguno hair)
    • CAH (clitoromegaly, primary amenorrhea)
  • HPI

    • onset
    • triggering event
    • location of hair growth
    • severity
  • ROS

    • fever, weight changes
    • headache
    • visual changes (loss of peripheral vision)
    • cardio: chest pain, palpitations
    • pulm: dyspnea
    • GI: bloating, mass, nausea, vomiting, diarrhea
    • endo: galactorrhea
    • obgyn: menstrual irregularity, primary amenorrhea
  • PMH

    • breast, ovarian cancer
  • FH

    • breast, ovarian cancer
  • SH

    • EtOH, tobacco, illicits
  • Meds

    • steroids
    • testosterone
    • danazol
  • Allergies

  • Px

    • vitals
    • gen impression, obesity vs emaciated, cushingoid features
    • facial hair, laguno hair
    • eye: visual fields
    • cardio
    • pulm
    • abd: flank mass, pelvic mass
    • pelvic exam, adnexal mass, clitoromegaly

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.