Gynaecological Problems – Long term consequences of PCOS

1. What is the Prevalence of Gestational diabetes mellitus in woman with PCOS when compared to general population

A. Twice as high
B. Thrice as high
C. Four times
D. Same as other woman
E. Ten times

2. Insulin resistance Is present in woman with PCOS

A. 85%
B. 95%
C. 55%
D. 45%
E. 65%

3. Cardiovascular dysfunction increase in both pre and post-menopausal woman with PCOS is linked to

A. High Androgen and low SHBG
B. Low androgen and High SHBG
C. High androgen and high SHBG
D. None of the above

4. High prevalence of PCOS is common in woman of

A. Caucasian origin
B. Nepal origin
C. Europe origin
D. South African

5. All are true about Rotterdam criteria except

A. Presence of polycystic ovaries
B. Oligoovuation
C. Anovulation
D. Hyperandrogenism features
E. Can be applied to Non-Caucasian woman as well.

6. Free androgen index is

A. Total testosterone divided by SHBGx 100
B. Free testosterone divided by Total testosterone x100
C. Free testosterone divided by SHBGx100
D. Total testosterone divided by 17hydroxy progesterone x100
E. None of the above

7. All are true regarding Congenital adrenal hyperplasia (CAH) except

A. Can present with hirsutism , deep voice, clitoral hypertrophy
B. Total testosterone level could be 7nmol/L
C. 17-hydroxyprogestrone to be measured in follicular phase
D. If 17-hydroxyprogestrone levels are borderline doesn’t need ACTH stimulation test
E. 17-hydroxyprogestrone to be done in Ashkenazi Jews

8. All are true regarding screening of type 2DM in woman with PCOS except

A. Done for woman with BMI>25kg/m2
B. AGE>40years
C. Family or personally history of Diabetes
D. 1hour post 75gm oral glucose tolerance test to be performed
E. Impaired glucose levels to be repeated annually

9. Impaired glucose tolerance level is diagnosed when

A. Fasting -6.5mmol/l& 2hours oral glucose tolerance test-8mmol/l
B. Fasting -6mmol/l& 2hours oral glucose tolerance test-7.5 mmol/l
C. Fasting -5.5mmol/l& 2hours -oral glucose tolerance test -7mmol/l
D. 2hours oral glucose tolerance testis 11.4mmol/l
E. None of the above

10. Sleep apnoea in woman with PCOS

A. Insulin resistance has no effect on this
B. Continuous positive airway pressure (CPAP) doesn’t relieve insulin resistance
C. Serum androgen levels are positively associated
D. Prevalence is not increased in obese woman
E. Need not ask partners regarding snoring

11. A Srilankan woman with Hirustism, Oligomenorrhoea. She is recently diagnosed with diabetes and started with oral hypoglycaemics. Her lipid profile is impaired. Her BMI is 28kg/m2. Her Blood pressure is 130/84mm of Hg What is the best treatment

A. She need to be started on statins for hyperlipidemia
B. Prescribe oral contraceptive pills
C. Refer her to physician to consider to start Antihypertensives
D. No need of lifestyle measures

12. Regarding long term consequences of PCOS

A. In absence of withdrawal bleeding , Endometrial thickness of 6mm needs further evaluation
B. 3 fold increased risk of developing endometrial cancer
C. No effect on psychological health
D. For every 1mm increase, endometrial thickness increased hyperplasia with odds ratio of 3

13. All are true regarding PCOS except

A. Bariatric surgery indicated for BMI > 40kg/m2
B. Weight loss is first line therapy to prevent long term consequences
C. Metformin use in PCOS have been licensed in Uk
D. BMI -< 35kg/m2 with comorbidity can be considered for Bariatric surgery

14. Use of metformin in woman with PCOS reduces androgen levels by

A. 5%
B.1 1%
C. 22%
D. 37%

15. Regarding Electrocautery in PCOS , all are true except

A. In woman with Normal BMI
B. Considered for anovulatory patients
C. Alternative to ovulation induction
D. 60%woman will have normalization of androgens with this.
E. In woman with High BMI

16. Up to what percentage of extra weight can be lost by bariatric surgery

A. 30%
B. 50%
C. 70%
D. 80%
E. 60%