Introduction Benign breast enlargement in males secondary to increased effective estrogen can be increased production or decreased degradation also result of decrease in androgens leaving estrogens unopposed May occur naturally throughout male life newborn secondary to high maternal estrogen puberty elderly secondary to androgen decrease Associated conditions cirrhosis genetic diseases Klinefelter syndrome increased aromatizing activity of Leydig cells high estrogen results in increased male breast cancer risk testicular feminization cancer choriocarcinoma of testis high production of hCG (an LH analogue) drugs estrogen marijuana flutamide blocks androgen receptors leuprolide blocks androgen production psychoactive drugs "Some Drugs Create Awesome Knockers" Spironolactone block androgen receptors, displaces estrogen from SHBG Digitalis intrinsic estrogen activity Cimetidine Alcohol Ketoconazole displaces estrogen from SHBG
QUESTIONS 1 of 1 1 Previous Next (M1.RP.14.24) A 14-year-old boy is accompanied by his mother to general pediatrics clinic for a routine visit. The boy has no complaints. He is doing well in school and has no medical illnesses. However, his mother reports that she is concerned about the growth in his chest. She states that over the past several months he has been developing what seem to be breasts. Vital signs are stable. Physical examination reveals the following in Figure A with the left chest slightly larger than the right chest. Both are soft to palpation and nontender. What is the next step in management? QID: 105422 FIGURES: A Type & Select Correct Answer 1 Order serum testosterone 20% (28/139) 2 Order serum estrogens 22% (30/139) 3 Order a mammogram of both breasts 1% (1/139) 4 Biopsy the left, larger breast 1% (1/139) 5 Reassurance 54% (75/139) M 3 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic
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