Hormonal Problems

A. Polycystic ovarian syndrome
B. Hyperprolactinemia
C. Classical adrenal hyperplasia
D. Androgen secreting tumours
E. Non-classical adrenal hyperplasia
F. Androgen secreting adrenal tumours
G. Serum Testosterone
H. Non-androgen cause - Phenytoin
I. Serum Prolactin
OPTION LIST

1. A 18-year-old girl presents with a recent onset of moderate facial hair growth and 4 months’ history of secondary amenorrhoea. Investigations by her GP showed a negative pregnancy test and normal LH, FSH and thyroid function test results. Pelvic ultrasound and blood glucose were normal. Serum androgen was elevated. Serum 17 –hydroxyprogesterone is 256ng/dl. The diagnosis is

2. A 21 year old woman presents with an excessive facial hair suddenly over the past few weeks, was found to have a Ferriman-Gallaway score of 16. The free testosterone values was 1.89ng/dl. The diagnosis is

3. A 21 year old woman presents with an excessive facial hair suddenly over the past few weeks, was found to have a Ferriman-Gallaway score of 16. The free testosterone values was 1.89ng/dl. She was further investigated with dehydroepiandrosterone Sulphate which was elevated. The diagnosis is

4. A 23 year old women presents with irregular menstrual cycles, and is complaining of weight gain despite trying to reduce weight. She is distressed about the developing acne and the facial hair. She was investigated and found to have normal uterus and ovaries, with mildly elevated testosterone and mildly elevated 17 –hydroxy progesterone. The possible diagnosis is

5.  A 27 year old women who has been having oligomenorrhoea, is complaining of developing facial hair. She has complaints of constant headache and occasionally complaints of galactorrohea. The investigation of choice to arrive at the diagnosis isription here!

6. A 25year old women has attended the GP clinic for excessive facial hair growth. She had been started on phenytoin 1year back for having seizures. She has been gaining weight and is complaining or irregular cycles for the past few months. The cause of her hirsutism is

A. Hypothyroidism
B. Pituitary Prolactinoma
C. Hyperprolactinemia
D. Polycystic ovarian disease
E. Cabergoline induced
F. Pituitary apoplexy
G. Drug-induced hyperprolactinemia
For each scenario described below, choose the single most appropriate diagnosis from the list of options above. Each option may be used once, more than once, or not at all.

7. A 19-year-old girl presents with secondary amenorrhoea and galactorrhoea. She has been on anti-psychotics since the age of 17 years. She has increased in weight in the past few months.

8. A 15-year-old girl presents with 4 months of amenorrhoea and discharge from the nipple for the past few weeks. She gives a history of visual disturbance for the last year. She has had consultations with the optometrist and was prescribed glasses and other investigations are normal. Clinical examination reveals bitemporal hemianopia

9. 27 year old women who is on cabergoline for pituitary adenoma was brought to the emergency with symptoms of sudden visual disturbance, severe headache, altered consciousness.