Gynaecological endocrinology: spironolactone counselling: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological endocrinology: spironolactone counselling

Sample item

A woman with PCOS is prescribed spironolactone for hirsutism. What counselling is essential?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Use reliable contraception because of the risk of feminising a male fetus

Spironolactone is an antiandrogen and can cause ambiguous genitalia in a male fetus, so effective contraception is needed. It tends to cause hyperkalaemia and menstrual irregularity, not hypokalaemia.

Option by option

  • A. Take potassium supplements to prevent hypokalaemia

    Spironolactone is potassium sparing and risks hyperkalaemia.

  • B. Expect regular cycles without any other treatment

    It often causes irregular bleeding and does not itself regularise cycles.

  • C. Use reliable contraception because of the risk of feminising a male fetus (correct)

    Correct. Its antiandrogen action can feminise a male fetus.

  • D. Avoid sunlight because of photosensitivity

    Photosensitivity is not the key counselling point for this drug.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Use reliable contraception because of the risk of feminising a male fetus. Spironolactone is an antiandrogen and can cause ambiguous genitalia in a male fetus, so effective contraception is needed.

Why is "Take potassium supplements to prevent hypokalaemia" not the answer?

Spironolactone is potassium sparing and risks hyperkalaemia.

Why is "Expect regular cycles without any other treatment" not the answer?

It often causes irregular bleeding and does not itself regularise cycles.

Why is "Avoid sunlight because of photosensitivity" not the answer?

Photosensitivity is not the key counselling point for this drug.

What concept does this question test?

It tests Gynaecological endocrinology: spironolactone counselling in OBG. It tends to cause hyperkalaemia and menstrual irregularity, not hypokalaemia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological endocrinology: spironolactone counselling?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.