Hormonal problems

1. Weight reduction of 5–10% can induce an improvement in hirsutism by

2. All are true about cyproterone acetate, except

3. Precocious puberty – all are true except

4. A 30-year-old woman presents to GP with increase in growth of hair on the chin, chest and back which she noticed for the last 3 months. She also gives history of deepening of voice, thinning of the scalp hair and frontal hair loss. Vulval examination reveals clitoromegaly. Which one of the following tests differentiates androgen-producing adrenal tumour from ovarian tumour?

5. What is the most common cause of central precocious puberty (CPP) in girls?

6. A five-year-old girl presents with a history of accelerated growth, thelarche, pubarche and menarche. Examination revealed light to dark brown spots, predominantly noticeable on one side of the body without crossing the midline. What is your differential diagnosis?

7. A 7 year old girl was brought to the GP with complaints of pubic and axillary hair growth. She is otherwise asymptomatic with no history of vaginal bleeding. On examination, pubic hair was sparse. Her breasts had not developed beyond a small bud. Physical examination did not reveal any abnormality with a normal linear growth pattern. What is the probable diagnosis

8. A 6+ years old child has been brought to the GP with advanced growth spurt with thelarche and adrenarche of Tanner classification stage 4 and with regular uterine bleeding for the last five months. Her bone age report showed she is two years more advanced than her chronological age. A pelvic ultrasound showed a pear-shaped uterus and with a 5 mm endometrial thickening and normal ovaries. She was otherwise asymptomatic with no signs of any significant medical illnesses. What is the probable diagnosis?

9. A 7 old girl is brought to the GP clinic because she has been having regular monthly bleeds for the last four months. You suspect gonadotropin-dependent precocious puberty. What is the gold standard to confirm your diagnosis?

10. A mother brings her five-year-old girl to the clinic. She noticed early excess pubic and body hair with clitoromegaly. She also noticed that her girl is taller than her peers. You suspect a mild non- classical form of CAH. What is the most sensitive investigation to diagnose mild forms of CAH?

11. Prolactin is increased in all the following situations, except

12. Regarding Bromocriptine, which of the statements is false: