Podcast
Questions and Answers
What is the typical management approach for simple gynaecomastia in an otherwise healthy adolescent?
What is the typical management approach for simple gynaecomastia in an otherwise healthy adolescent?
What should be done if rapid-onset gynaecomastia occurs in a 30-year-old male with no apparent cause?
What should be done if rapid-onset gynaecomastia occurs in a 30-year-old male with no apparent cause?
What is the expected outcome for adolescents with gynaecomastia?
What is the expected outcome for adolescents with gynaecomastia?
What effect does stopping a causative drug, like anabolic steroids, typically have on gynaecomastia symptoms?
What effect does stopping a causative drug, like anabolic steroids, typically have on gynaecomastia symptoms?
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When should a patient be referred to a specialist breast clinic regarding gynaecomastia?
When should a patient be referred to a specialist breast clinic regarding gynaecomastia?
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What typically causes gynecomastia in males?
What typically causes gynecomastia in males?
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What is a common cause of gynecomastia in adolescents?
What is a common cause of gynecomastia in adolescents?
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Which hormone's elevated levels can lead to gynecomastia?
Which hormone's elevated levels can lead to gynecomastia?
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A patient with gynecomastia should undergo which examination to rule out malignancy?
A patient with gynecomastia should undergo which examination to rule out malignancy?
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Which drug is commonly linked to causing gynecomastia?
Which drug is commonly linked to causing gynecomastia?
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What distinguishes gynecomastia from pseudogynecomastia on physical examination?
What distinguishes gynecomastia from pseudogynecomastia on physical examination?
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What should be considered as a common cause of gynecomastia in young men based on clinical practice observations?
What should be considered as a common cause of gynecomastia in young men based on clinical practice observations?
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In adults, what could be a sign that gynecomastia is related to a more serious condition?
In adults, what could be a sign that gynecomastia is related to a more serious condition?
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Study Notes
Gynaecomastia: Male Breast Enlargement
- Gynaecomastia is the enlargement of male breast glandular tissue.
- Common in adolescents and men over 50, and newborns (resolving).
- Caused by hormonal imbalance: higher oestrogen, lower androgen (e.g., testosterone).
- Oestrogen stimulates breast development; androgens inhibit it.
- Prolactin also stimulates breast tissue and milk production; Hyperprolactinaemia (high prolactin) causes gynaecomastia.
- Dopamine inhibits prolactin; dopamine antagonists (e.g., antipsychotics) can elevate prolactin, causing gynaecomastia.
- Frequently idiopathic (no identifiable cause).
- Physiological in adolescents due to high oestrogen during puberty; resolves naturally.
- Link between gynaecomastia and Leydig cell testicular tumours (2% of cases).
- Important to examine testes for tumours.
- Liver failure and hyperthyroidism should be considered.
- Spironolactone is a potential cause.
- Anabolic steroid use a common cause in young men.
- Idiopathic gynaecomastia common.
- Differentiate from pseudogynaecomastia (breast enlargement due to obesity):
- Gynaecomastia: firm tissue behind areolas (glandular/ductal tissue).
- Pseudogynaecomastia: soft, evenly distributed adipose tissue.
Diagnosis and Management
- Investigations depend on history and examination.
- Watchful waiting for simple gynaecomastia in healthy adolescents.
- In-depth investigations for unexplained rapid-onset gynaecomastia in adults.
- Management based on underlying cause.
- Removal of causative drugs (e.g., anabolic steroids) usually resolves the issue.
- Referral to breast clinic if cause unclear or cancer suspected.
- Treatment options: include interventions for problematic cases (pain/psychological distress).
- Gynaecomastia almost always resolves in adolescents.
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Description
This quiz covers the key aspects of gynaecomastia, the enlargement of male breast tissue, focusing on its causes, hormonal influences, and potential linked conditions. It addresses physiological situations like puberty and the role of various hormones, including oestrogen and prolactin. Test yourself on the important factors involved in diagnosing and understanding this condition.
