Our blueprint estimate puts 15–20 of the 200 questions in endocrinology, about 8.8% of the paper, spread across both papers. It is our estimate, not a figure published by the RCOG. One of the heaviest-weighted areas on the paper.
15–20
of 200
9
in our syllabus map
cell_function
2 other areas
Endocrinology is mostly pathways: which hormone is made where, by which enzyme, and what happens when a step fails. The questions reward drawing the steroid pathway from memory and then reasoning about which hormones back up and which fall.
The 9 syllabus topics we map to Endocrinology for Part 1.
Theca cells make androgens under LH; granulosa cells convert them to oestrogens with aromatase under FSH. Drugs that block aromatase act at that conversion step. Placental hormones follow their own division of labour between mother, fetus and placenta.
Most cases are 21-hydroxylase deficiency, with accumulation of 17-hydroxyprogesterone and virilisation of an affected female fetus. Learn the other enzyme defects by what they do to blood pressure and to sex steroid production rather than as isolated names.
Diagnosis rests on a combination of anovulation, hyperandrogenism and polycystic ovarian morphology, with two of the three sufficient once other causes are excluded. Insulin resistance is central to the pathophysiology, and unopposed oestrogen explains the endometrial risk.
Reproductive Endocrinology International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (PCOS)
Binding globulin rises in pregnancy, so total thyroxine rises while the free fraction stays in range. Total T4 is therefore the wrong test to interpret. Prolactin is the one pituitary hormone under tonic inhibition, by dopamine, which is why dopamine agonists treat its excess.
Reproductive Endocrinology Management of Thyroid Disorders in Pregnancy
Redraw the steroid pathway until you can do it without looking, then ask of every question which enzyme step has been altered. Group the clinical syndromes by the step they affect rather than by name. Revise the feedback loops last, as a set of rules: which hormone inhibits which, and which single exception reverses the sign at mid-cycle.
Part 1 is 200 single best answer questions across two papers with no negative marking, so an informed guess always beats a blank. Endocrinology feeds directly into the clinical modules of Part 2, where the same pathways reappear as subfertility, PCOS and thyroid disease management. Time spent here is repaid twice.
Every question is original and written from published RCOG and NICE guidance, and every explanation cites the guideline it came from. Free: 5 days full access, then 50 questions. No card.
Published RCOG and NICE guidance summarised for revision, with the source cited on every page.
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