A 30 year old woman has developed increased facial hair and acne for last 5 months. She has noticed deepening of voice and clitoris enlargement. On physical examination her height is 170 cm, weight is 95kg, BP=130/75 with abdominal obesity. There is no evidence of striae or bruising. All of the following would be impoant steps in clinical assessment of patient, except?
The clinical history is of hirsutism and development of virilisation process due to changes in voice. Virilisation indicates ovarian or adrenal source of DHEAS. Hormonal evaluation of testosterone and DHEAS hence becomes logical. Family history is impoant as in some families' hirsutism can be seen. USG for ovary evaluation is an insensitive test for diagnosis as polycystic ovaries can be found without any androgen excess or females can have androgen excess while ovaries are normal.
Family history
Serum testosterone
Serum DHEAS
USG abdomen
Disorders of Adrenal Gland