MBBS OSCE · obstetrics-gynaecology
OSCE — Polycystic Ovary Syndrome
Eight-minute OSCE station on Polycystic Ovary Syndrome: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Polycystic Ovary Syndrome.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Polycystic ovary syndrome (PCOS) is a heterogeneous, lifelong reproductive and metabolic disorder of reproductive-age women characterised by ovulatory dysfunction, hyperandrogenism (clinical or biochemical), and polycystic ovarian morphology (PCOM), defined by the Rotterdam 2003 consensus as any two of those three features, after exclusion of other causes. Insulin resistance with compensatory hyperinsulinaemia is the central driver in 70 to 80% of patients, augmented by gonadotropin dysregulation (elevated LH:FSH ratio) and low-grade chronic inflammation. Presentation clusters around oligomenorrhoea or amenorrhoea, hirsutism (modified Ferriman-Gallwey score over 4 to 6), acne, central obesit
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Prolonged amenorrhoea (over 3 months) or endometrial thickness on ultrasound in |
| Safety | Rapid-onset severe virilisation (clitoromegaly, voice deepening, frontal balding |
| Safety | Late-onset congenital adrenal hyperplasia mimics PCOS: measure early-morning 17- |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.