By Stephany Sosa & Brigitte Gomez Ms. Miller p. 2 & 3 Practicum I

1. By Stephany Sosa & Brigitte Gomez Ms. Miller p. 2 & 3 Practicum I

2. What is Virilism? • Virilism is the development or premature development of male secondary sexual characteristics caused by male sex hormones (androgens) excessively produced by the adrenal gland.

3. Causes • In infants and children, this disease is usually the result of adrenal gland enlargement that can be seen at birth, which is called congenital adrenal hyperplasia. • The cause is usually a genetic problem that leads to severe enzyme deficiencies. In rare cases, adrenal virilism is caused by an adrenal gland tumor.

4. Causes Cont. • The tumor can be harmlessor possibly cancerous. • Sometimes in women, virilism can be caused by a tumor in the woman's ovary

5. Signs & Symptoms (Girls) • Newborn girls with adrenal virilism have external sex organs that seem to be a mixture of male and female organs.

6. Signs & Symptoms (Boys) • Newborn boys with the disorder have enlarged external sex organs, and these organs develop at an abnormally rapid pace.

7. Signs & Symptoms Cont. • Children with congenital adrenal hyperplasia begin growing abnormally fast, but they stop growing earlier than normal. Later in childhood, children with this disease are typically shorter than normal kids.

8. What is CAH? • Congenital Adrenal Hyperplasia:"is a genetic disorder characterized by a deficiency in the hormones cortisol and aldosterone and an overproduction of the hormone androgen, which is present at birth and affects sexual development" as stated on The Free Dictionary.com.

9. Signs & Symptoms Cont. • Women with virilism may develop facial hair, usually their menstrual cycles are occasional or absent. • They may also develop a deeper voice, a more noticeable Adam's apple, and other male features. • Some women may even develop an enlarged clitoris.

10. Test & Diagnosis • To find out the regular diagnosis for Virilism the patient is asked to get blood samples drawn. • Once finished it is taken to the laboratory where it is visualized and measured for the concentration of different hormones that are in the blood of the body.

11. Tests & Diagnosis Cont. • If diagnosed with this disease and a tumor is found, special x-rays may be done to visualize the tumor in the body. • The final diagnosis will depend on what the tumor biopsy reveals about the tissue of the mass.

12. Treatments & Medications • Information about the tumor cell type and the spread of the tumor is used to decide the best kind of treatment for a particular patient. • If the tumor is cancerous, the patient will require special treatment depending on how far the cancer has advanced.

13. Treatments & Medications Cont. • Treatment for cancerous tumors can include surgery, medications used to kill cancer cells which is called chemotherapy, and radiation therapy. • Sometimes the doctor must remove the adrenal gland and the surrounding tissues. If the tumor is harmless, then surgically removing the tumor may be the best option.

14. Treatments & Medications • Medication for Adrenal virilism include daily doses of a glucocorticoid, prednisone, hydrocortisone is usually given to infants. • Laboratory tests are usually needed ever so often to adjust the dosage. Sometimes it may require surgery to make patient's external sex organs appear more normal.

15. Emerging Trend • There is no certain emerging trend on the disease, Virilism. • Although, there are some cases that show the new generation of children seem to be developing a lot faster and sooner than past generations, there is no exact conformation that this is due to Virilism.

16. What does Virilism look like? Common Areas Adam's Apple

17. Pixar

18. Review Questions • Gloria turned 21 and began to notice that she was developing an extreme baldness pattern and her menstrual cycle is infrequent. Her mother mentioned that her voice seemed to be getting deeper each day. This symptoms indicated that she has what disease? A. Hashimoto's disease B. Virilism C. Grave's disease D. Turner Syndrome

19. Review Questions 2. Jessica has just given birth to a baby boy. While she was changing his diaper she noticed he had an enlarged external sex organ. He was diagnosed with Virilism. What other symptoms can occur with this disease? A. Begins growing fast B. Turns into a girl C. Grow facial hair at a rapid rate D. Has infrequent menstrual cycle

20. Review Questions 3. In the case of Virilism disease there is a specific area in the body that causes this disease. Where does it occur? A. Intestines B. Brain C. Kidney D. Adrenal Gland

21. Review Questions 4. Grace, a patient with Virilism, has an enlarged tumor in her adrenal gland that can possibly be cancerous. What treatment should she take? A. Antibiotics B. Daily doses of glucocorticoid C. Levothyroxine D. Chemotherapy/Radiation

22. Review Questions 5. What age can Virilism be developed in women? A. At birth B. Puberty C. Later in life D. Both A & C

23. Video • This video just gives you background information on the function of the adrenal glands because it ties in with our disease. http://www.youtube.com/watch?v=eGJRH48-UV4