PCOS

Question 1

Rotterdam criteria?

Answer 1

At least 2/3:

1) Oligoovulation or anovulation, presenting with irregular or absent menstrual periods
2) Hyperandrogenism - hirsutism and acne
3) Polycystic ovaries on ultrasound (or ovarian volume of more than 10cm3)

Question 2

Sign of insulin resistance?

Answer 2

Acanthosis nigricans

Question 3

Key hormone test that will be raised?

Answer 3

LH and LH:FSH ratio

Also test - prolactin, TSH and testosterone

Question 4

Pelvic US/TVS US (gold standard for diagnosis)?

Answer 4

‘string of pearls’

1) 12 or more developing follicles in one ovary
2) Ovarian volume of more than 10cm3

Question 5

Screening for diabetes?

Answer 5

OGTT

• impaired fasting (before glucose) - 6.1-6.9
• impaired tolerance - 7.8-11.1 at 2 hours
• diabetes - 11.1 at 2 hours

Question 6

Options for reducing the risk of endometrial hyperplasia

Answer 6

• Mirena

- induce bleed -> COCP, cyclical progestogens

Question 7

Management of infertility?

Answer 7

WEIGHT LOSS
Clomifene
Laparoscopic ovarian drilling
In vitro fertilisation (IVF)

Question 8

Screening during pregnancy?

Answer 8

OGTT at 24-28wks for gestational DB

Question 9

Management of hirsutism?

Answer 9

Dianette (co-cyprinidol) - VTE risk

Topical elfornithine

Question 10

Management of acne?

Answer 10

Co-cyprinidol (Dianette)