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Polycystic ovary syndrome — DRCOG MCQ

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ModerateGynaecologyPolycystic ovary syndromeDRCOG

A 23-year-old woman presents with irregular cycles, acne and increased facial hair. BMI is 31 kg/m². Pregnancy test is negative and pelvic ultrasound shows enlarged ovaries with multiple follicles. What is the most likely diagnosis?

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Correct answer: B — Polycystic ovary syndrome

Oligomenorrhoea, clinical hyperandrogenism and polycystic ovarian morphology support PCOS after pregnancy is excluded. Cushing syndrome and androgen-secreting tumours are important differentials when features are severe or rapid, but the pattern here is typical PCOS. Premature ovarian insufficiency usually presents with raised gonadotrophins and oestrogen deficiency symptoms. The pearl is to assess metabolic risk as well as menstrual symptoms.

Reference: NICE CKS polycystic ovary syndrome; International PCOS guideline