frank100
Forum Guru
Topics: 48
Posts: 586
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A 32 Y/O NULLIGRAVID WOMAN COMES TO THE PHYSITIAN BECAUSE SHE HAS BEEN UNABLE TO CONCEIVE FOR 3 YEARS, MENARCHE WAS AT THE AGE OF 13 YEARS. MENSES OCCUR AT IRREGULAR 1 TO 6 MONTH INTERVAL AND OFTEN LAST MORE THAN TWO WEEKS. SHE HAS BEEN SEXUALLY ACTIVE SINCE THE AGE OF 17 YEARS, AND HAS NEVER USED CONTRACEPTION. SHE WEIGHTS 100KG, AND 168CM TALL. EXAMINATION SHOWS INCREASED FACIAL AND ABDOMINAL HAIR, EXCESSIVE SEBUN PRODUCTION, AND FACIAL ACNE VULGARIS. PELVIC EXAMINATION SHOWS NORMAL EXTERNAL GENITALIA, A WELL ESTROGENIZED VAGINA, AND A NORMAL CERVIX AND UTERUS. BIMANUAL EXAMINATION SHOWS ENLARGED (5 X 5CM) OVARIIES BILATERALY, THEY ARE MILDLY TENDER AND MULTICYSTIC ON PALPATION. WHICH OF THE FOLLOWING IS THE NEXT STEP IN MANAGEMENT?
A)MEASUREMENT OF EARLY MORNING SERUM CORTISOL LEVEL.
B)MEASUREMENT OF SERUM TESTOSTERONE AND DEHIDROEPIANDROSTERONE SULFATE LEVELS
C)DEXAMETHASONE SUPPRESION TEST
D)PITUITATY STIMULATION TEST
E)EXPLORATORY OPERATION
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| drk1980
Forum Guru
Topics: 147
Posts: 1,038
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B...suspecting PCOS
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| frank100
Forum Guru
Topics: 48
Posts: 586
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a better choice would have been f)measument of LH and FSH.
but b) is a good option, and can lead you to the diagnosis confirmation.
another clue is that the rest of the options are wrong, if you apply the diagnosis, which, in that case is PCOS.
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