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OSCE question 6. |
Marks |
A
20 year old woman presents with infrequent periods since the menarche at the age
of 16. She has mild acne but no other abnormal feature. She wishes to conceive.
1. What
is the likeliest diagnosis?
| Polycystic ovary syndrome. |
1 |
2. What
investigations will you arrange? List four.
| Ovarian scan. Follicular phase LH or LH:FSH. BMI. Rubella & chickenox immunity. Semen analysis. Possibly prolactin & androgens. |
4 |
3. What
treatments will you arrange? List two.
| Dietary advice if appropriate - weight loss helpful for the overweight girl with PCOS. Rubella & chickenpox vaccine if needed. Clomiphene. |
2 |
4. What
counselling will you give?
| Pre-pregnancy counselling. Side-effects and risks of clomiphene: multiple pregnancy, ovarian cysts and ovarian hyperstimulation. Theoretical increase in risk of ovarian cancer. |
2 |
5. What
follow-up investigation will you arrange?
| Luteal phase progesterone to confirm ovulation once regular cycles have been established. |
1 |