MBBS OSCE · General Medicine
OSCE — Polycystic Ovary Syndrome (PCOS)
Eight-minute OSCE station on Polycystic Ovary Syndrome (PCOS): 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 (PCOS).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder of reproductive-age women (around 8 to 13 percent), diagnosed by the Rotterdam criteria — TWO of THREE: oligo/anovulation, clinical or biochemical hyperandrogenism (hirsutism, acne, elevated free testosterone), and polycystic ovaries on ultrasound — after excluding mimics (thyroid, prolactin, Cushing, non-classic CAH, androgen-secreting tumour). Insulin resistance and the metabolic syndrome are central, driving obesity, type 2 diabetes and cardiovascular risk. Presentation includes irregular periods, hirsutism, acne, infertility and weight gain. Management is lifestyle first (5 to 10 percent weight loss), then combined oral
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 | Irregular periods with hirsutism and weight gain — screen for PCOS after excludi |
| Safety | PCOS with prolonged amenorrhoea and no endometrial protection — risk of endometr |
| Safety | PCOS with acanthosis nigricans and obesity — screen for type 2 diabetes (HbA1c, |
| 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.