Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            gh levels of male 
hormones prevent the ovaries from producing hormones and making eggs normally. Genes, 
insulin resistance, and inflammation have all been linked to excess androgen production. 
Genes 
Studies show that PCOS runs in families. It’s likely that many genes contribute to the 
condition. 
Insulin resistance 
Up to 70 percent of women with PCOS have insulin resistance, meaning that their cells can’t 
use insulin properly. When cells can’t use insulin properly, the body’s demand for insulin 
increases. The pancreas makes more insulin to compensate. Extra insulin triggers the ovaries 
to produce more male hormones. Obesity is a major cause of insulin resistance. Both obesity 
and insulin resistance can increase your risk for type 2 diabetes. 
 
 
Pharmacology-2          Dietitian Program         2024-2025                Prof Dr Manar A Nader
 
 
22 | P a g e  
 
Inflammation 
Women with PCOS often have increased levels of inflammation in their body. Being 
overweight can also contribute to inflammation. Studies have linked excess inflammation to 
higher androgen levels 
 
Common symptoms of PCOS 
Some women start seeing symptoms around the time of their first period. Others only 
discover they have PCOS after they’ve gained a lot of weight or they’ve had trouble getting 
pregnant. 
The most common PCOS symptoms are: 
• Irregular periods. A lack of ovulation prevents the uterine lining from shedding every 
month. Some women with PCOS get fewer than eight periods a year. 
• Heavy bleeding. The uterine lining builds up for a longer period of time, so the periods 
you do get can be heavier than normal. 
• Hair growth. More than 70 percent of women with this condition grow hair on their 
face and body — including on their back, belly, and chest (hirsutism). 
• Acne. Male hormones can make the skin oilier than usual and cause breakouts on 
areas like the face, chest, and upper back. 
• Weight gain. Up to 80 percent of women with PCOS are overweight or obese. 
• Male-pattern baldness. Hair on the scalp gets thinner and fall out. 
• Darkening of the skin. Dark patches of skin can form in body creases like those on the 
neck, in the groin, and under the breasts. 
• Headaches. Hormone changes can trigger headaches in some women. 
How PCOS affects your body 
Having higher-than-normal androgen levels can affect your fertility and other aspects of your 
health. 
 
 
Pharmacology-2          Dietitian Program         2024-2025                Prof Dr Manar A Nader
 
 
23 | P a g e  
 
Infertility 
To get pregnant, you have to ovulate. Women who don’t ovulate regularly don’t release as 
many eggs to be fertilized. PCOS is one of the leading causes of infertility in women. 
Metabolic syndrome 
Up to 80 percent of women with PCOS are overweight or obese . Both obesity and PCOS 
increase your risk for high blood sugar, high blood pressure, low HDL (“good”) cholesterol, 
and high LDL (“bad”) cholesterol. 
Together, these factors are called metabolic syndrom

            Quiz: