1. A 24-year-old female presents with secondary amenorrhea and hirsutism. According to the Rotterdam criteria, which of the following combinations is sufficient for a diagnosis of Polycystic Ovary Syndrome (PCOS), after excluding other etiologies?
2. What is the very first investigation to be performed in any woman of reproductive age presenting with secondary amenorrhea?
3. A patient’s hirsutism is being evaluated. A significantly elevated level of dehydroepiandrosterone sulfate (DHEAS) is most indicative of an androgen excess originating from which source?
4. The Ferriman-Gallwey score is used to objectively assess:
5. A 28-year-old female with secondary amenorrhea undergoes a progestin challenge test. She experiences withdrawal bleeding after the course of progestin. This result indicates:
6. Which of the following differentiates hirsutism from hypertrichosis?
7. A patient with hirsutism is diagnosed with non-classical (late-onset) congenital adrenal hyperplasia. Which laboratory finding is most characteristic of this condition?
8. A 19-year-old competitive long-distance runner presents with a 9-month history of amenorrhea. Her BMI is 17.5 kg/m². Lab tests show low FSH, low LH, and low estradiol. What is the most likely diagnosis?
9. What is the primary mechanism by which combined oral contraceptives (COCs) improve hirsutism in patients with PCOS?
10. A 32-year-old woman presents with secondary amenorrhea following a dilatation and curettage (D&C) for postpartum hemorrhage. She fails to have withdrawal bleeding after a progestin challenge test and an estrogen-progestin challenge test. What is the most likely diagnosis?
11. The rapid onset of severe hirsutism accompanied by virilizing signs such as clitoromegaly and voice deepening should raise suspicion for:
12. A 29-year-old woman presents with amenorrhea for 8 months. Her serum FSH level is markedly elevated on two separate occasions. This finding is most consistent with:
13. Hyperprolactinemia leads to amenorrhea primarily by inhibiting the pulsatile secretion of which hormone?
14. Spironolactone is often used in the management of hirsutism. Its primary mechanism of action for this indication is:
15. A patient with Cushing’s syndrome develops hirsutism. This is typically due to excess production of androgens stimulated by:
16. Sheehan’s syndrome, a cause of secondary amenorrhea, is characterized by postpartum pituitary necrosis. The classic history involves:
17. Which of the following thyroid abnormalities is a recognized cause of secondary amenorrhea and/or galactorrhea?
18. The most appropriate imaging modality to evaluate a suspected pituitary cause for secondary amenorrhea (e.g., prolactinoma) is:
19. For a patient with PCOS who desires fertility, which of the following is considered a first-line agent for ovulation induction?
20. A 22-year-old female presents with rapidly progressing hirsutism and virilization. Her serum total testosterone is >200 ng/dL and DHEAS is normal. Which of the following is the most likely diagnosis?
21. In a patient with secondary amenorrhea and galactorrhea, what is the next most appropriate step in the diagnostic workup after a negative pregnancy test?
22. Which of the following medications is known to cause hypertrichosis, not hirsutism?
23. The underlying pathophysiology of functional hypothalamic amenorrhea involves:
24. A patient with PCOS is at an increased long-term risk of developing all of the following EXCEPT:
25. Finasteride is a treatment option for hirsutism. It works by:
