SDL CLASS
6-11-24
Polycystic Ovary Syndrome
(PCOS)
MCQ’S
The following hormone is raised in polycystic
ovarian syndrome:
a. 17 – OH progesterone
b. Follicular stimulating hormone
c. Luteinizing hormone
d. Thyroid stimulating hormone
MCQ’S
Which of the following is the most likely
diagnosis in a 27-year-old obese woman
presenting with Oligomenorrhea, infertility
and hirsutism?
a. Polycystic ovaries
b. Endometriosis
c. Pelvic inflammatory disease
d. Turner’s syndrome
MCQ’S
• In PCOD symptoms and signs seen are:
a. Amenorrhoea/ Anovulation
b. Infertility
c. Hirsutism/ Acne
d. All of the above
MCQ’S
Appearance of Ovaries on USG Photograph is
found in
a. Ovarian cyst
b. PCOD
c. Ovarian cancer
d. Teratoma cyst
A patient has just had a pelvic ultrasound which showed
bilateral polycystic ovaries however has normal
menstrual cycles and androgrn levels. Your patient asks
,so does this mean I have PCOS ?How would you
respond to your patient?
a. Since your ultrasound shows us cysts on your ovaries
,we would diagnose you with pcos
b. Women who are postmenopausal can only have PCOS
c. In order to be diagnosed with PCOS,you would need
to have irregular menstrual cycles and or elevated
androgen levels along with cysts on your ovaries
d. You must have low androgen levels to be diagnosed
with PCOS
DIAGNOSTIC CRITERIA – ROTTERDAM
CRITERIA (2003)
CLINICAL
• Ovulatory dysfunction such as oligomenorrhea
or amenorrhea.
CLINICAL / BIO-CHEMICAL
• Clinical (hirsutism/acne/alopecia) or biochemical evidence
of hyperandrogenism i.e. S. testosterone between 70-150
ng/ dl.
ULTRASOUND
• Polycystic ovarian morphology on USG scan defined as the
presence of 12 or more cysts size: (2-9 mm) ] in any one ovary or
both ovaries, with enlarged ovaries I (>10 ml) and other criteria
being excluded.
Any two of the following three criteria should be present to diagnose a patient
having PCOD after excluding other etiologies.
MCQ’S
A 20-year old average weight female complains of
oligomenorrhea along with facial hair. Preliminary
investigations reveal raised free testosterone levels.
USG Pelvis: The ovary shows normal morphology.
Which of the following could be likely etiology
a. Idiopathic hirsutism
b. PCOD
c. Adrenal hyperplasia
d. Testosterone secreting tumor
MCQ’S
The following is/are the criteria required to
diagnose polycystic ovarian syndrome EXCEPT:
a. Hirsutism
b. Elevated low density lipoprotein cholesterol
c. Elevated testosterone
d. Ovary volume > 10 cm 3
MCQ’S
Which sonographic parameter(s) is/are included
in the ultrasound criteria of PCOM, Except?
a. Follicle number per ovary (FNPO)
b. Ovary volume
c. Stromal echogenicity
d. Stromal blood flow
MCQ’S
All are true about PCOD except:
a. Metformin is used for treatment
b. Acanthosis nigra may be associated
c. Occur in postmenopausal women only
d. Associated with obesity
Positive progesterone challenge test in a
patient of secondary amenorrhoea, seen in :
a. Asherman Syndrome
b. Endometrial TB
c. Hypopituitarism
d. PCOD
All of the following hormonal observations in
PCOD are true, EXCEPT:
a. High LH : FSH
b. High Androgens
c. Low Prolactin
d. High LH
HORMONES INCREASED HORMONES DECREASED
• Androgens (Testosterone, • Follicle-stimulating hormone (FSH)
Androstenedione, DHEA, DHEAS)
• Progesterone (due to anovulation)
• Luteinizing hormone (LH > 10 IU/L)
• Sex hormone-binding globulin
• Estrone (SHBG)
• Total free estrone • HDL & Apoprotein A-l
• Insulin (> 10 m IU/L due to insulin
resistance)
• Prolactin (in some patients)
• LDL cholesterol and triglycerides .
• AMH
When assessing a patient’s serum hormone
levels, what would be consistent with PCOS?
a. Decreased testosterone and decreased
estrogen
b. Increased testosterone and LH, decreased
FSH
c. Decreased testosterone and decreased
prolactin
d. Decreased LH and Increased FSH
In Polycystic ovarian diseases, all of the
following are seen except:
a. Endometrial carcinoma
b. Increased FSH
c. Hirsutism
d. Insulin resistance
HAIR-AN syndrome is seen in -
a. PCOD
b. Endometriosis
c. CA ovary
d. Adrenal tumors
Acanthosis nigricans (areas of thickened
,darkened skin),a symptom of polycystic ovary
syndrome ,is caused by which of the
following?
a. Increased serum oestrogen levels
b. Increased serum progesterone levels
c. Insulin resistance
d. Obesity
In polycystic ovary syndrome ,estrogen levels are
elevated ,increasing the risk of which of the
following?
a. Metabolic syndrome
b. Endometrial cancer
c. Hirsutism
d. Hypertension
Polycystic ovarian syndrome is the prominent
cause of ------------for women
a. Obesity
b. Dyslipidemia
c. Insulin resistance
d. Infertility
PCOS has been linked to an increased risk of
developing other health complications. Which
ones?
a. Insulin resistance and type 2 diabetes
b. High blood cholesterols and fats
c. Cardiovascular disease (conditions affecting
your heart and blood vessels)
d. All of the above
Most common cause of hirsutism
a. Polycystic ovary disease
b. Arrhenoblastoma
c. Cushing syndrome
d. Congenital adrenal hyperplasia
The first step in the management of hirsutism
due to Stein-Leventhal syndrome is
a. OCP
b. HMG
c. Spironolactone
d. Bromocriptine
A 16-year-old girl presents with rapid onset
hirsutism and amenorrhea. Best investigation
is
a. Testosterone estimation
b. Dihydroepiandrosterone
c. Adrenocorticoids
d. LH and FSH estimation
SHORT ESSAY:
Discuss the etiology clinical features and
management of PCOD
Enumerate the causes and describe the
investigations and management of
hyperandrogenism
SHORT ESSAY:
• Discuss the causes ,investigation and
management of Hirsutism
• Discuss the diagnosis of ovarian
hyperstimulation syndrome
THANK YOU