PCOS

Question 1

what are the three criteria needed for PCOS?

Answer 1

polycystic ovaries
oligo menorrhoea or amenorrhoea
hyperandregonsim (acne, hirsutism etc)

Question 2

what 4 things is PCOS associated with?

Answer 2

high lipids
hypertension
insulin sensitivity
obesity

Question 3

investigations?

Answer 3

OGTT

Pelvic ultrasound

Question 4

diagnostic investigations

Answer 4

raised free testosterone

more than 12 ovarian follicles or ovarian volume over 10 cm

Question 5

why do you get increased free androgens?

Answer 5

hyperinsulinaemia causes increased testosterone released from ovaries

Question 6

management of PCOS?

Answer 6

initially weight loss/exercise/smoking cessation

Question 7

what do you need to monitor carefully in PCOS?

Answer 7

diabetes
hypertension
hyperlipidaemia

Question 8

medical management ?

Answer 8

COCP - controls periods and treats hirustism

metformin - increases insulin resistance and ovulatory function

Question 9

fertility treatment ?

Answer 9

metformin
clomifene citrate
gonadotrophins (LH and FSH)
IVF

Question 10

clomifene citrate what is it more likely to cause?

Answer 10

twins and ovarian cancer