Breast enlargement

Question 1

What age does gynynaecomastia occur in?

Answer 1

Young e.g 35

Question 2

What common malignancy does gynynaecomastia present as the only symptom of?

Answer 2

Testicular cancer

Question 3

Name the main causes of gynyaecomastia (using the letters)

Answer 3

G Genetic disorder (Klinefelter’s)
Y Young boy (pubertal)
N Neonate
A Alcoholism
E oEstrogen
C Cirrhosis/Chronic kidney disease/Cimetidine/Calcium channel blockers
O Old age (senile gynaecomastia)*
M Marijuana
S Spironolactone
T Tumours (testicular and adrenal)/hyperthyroidism
I Isoniazid/Inhibition of testosterone (as in testicular atrophy)
A Anti-fungal (ketoconazole), Angiotensin-converting enzyme (ACE) inhibitors, 5-Alpha reductase inhibitors (finasteride)

Question 4

What genetic disorder can cause gynyaecomastia? And what gene is it?

Answer 4

Klinefelter’s

47XXY

Question 5

Drugs causing gynyaecomastia (7)

Answer 5

• Cimetidine
• Calcium channel blockers
• Spironolactone
• Insoniazid
• Anti-fungals
• ACE inhibitors
• 5 alpha reductase inhibitors