Gynecology MCQ,

30 yr old with hirsutism,infertility and obesity- diagnosed to be PCOS .what is the NOT the treatment option
a) Oral contraceptive pills
b) Tamoxifen
c) clomiphene citrate
d) spironolactone


ANS b

Polycystic Ovarian Syndrome (PCOS)(AI-2011***)
* Hyperandrogenism in association with amenorrhea or oligomenorrhea.
* Lean patients with PCOS generally have high LH levels in the presence of normal to low levels of FSH(elevated LH/FSH ratio) and estradiol.
* The LH/FSH abnormality is less pronounced in obese patients in whom insulin resistance is a more prominent feature.
Treatment
* These patients are at risk for the development of dysfunctional bleeding and endometrial hyperplasia.
* Endometrial protection can be achieved with the use of oral contraceptives or progestins (medroxyprogesterone acetate prometrium).
* Spironolactone, which functions as a weak androgen receptor antagonist.
* Clomiphene citrate is highly effective as first-line treatment, with or without the addition of metformin.

All are physiological changes during pregnancy except
a) distended neck veins
b) systemic hypotension
c) pedal edema
d) dyspnoea
ANS B