A 20-year-old woman comes to clinic for an annual physical examination. She has no complaints. She has no significant medical or surgical history. She is currently taking oral contraceptive pills because of her irregular menstrual cycles. She attained menarche at age 13 and has had irregular cycles since. She has never been sexually active. Her family history is positive for hypertension and obesity in both her parents. On examination, her blood pressure (BP) is 120/85 mm Hg, her pulse is 78 beats/min, and her respiratory rate is 14 breaths/min. Her weight is 188 lb, and she is 63-in tall. Her physical examination is unremarkable except for a brownish/black, velvety thickening of the skin on the back of her neck, hirsutism, and abdominal obesity.
What are the clinical issues that need to be addressed during this preventive visit?
What is your next step in the evaluation of this patient?
What are the therapeutic options available for this patient?
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