Goljans Flashcards
What is the clinical presentation of lichen sclerosus?
Thinned epidermis of the vulva; parchment-like skin
What is the clinical presentation of lichen simplex chronicus?
Leukoplakia (hyperplasia) of the vulva
What is the clinical presentation of papillary hidradenoma?
Painful apocrine gland tumor; nodule on labia majora
What causes vulvar intraepithelial neoplasia?
HPV 16
What are the risk factors for squamous cell carcinoma of the vulva?
HPV 16
What is extramammary Paget disease?
Intraepithelial adenocarcinoma; PAS positive
What laboratory test can be used to differentiate extramammary Paget disease from vulvar melanoma?
PAS
What is the clinical finding in Rokitansky-Küster-Hauster syndrome?
Vagina/uterus underdeveloped or absent
What is a Gartner cyst?
Wolffian duct remnant in the lateral wall of the vagina
What is the most common sarcoma in girls?
Embryonal rhabdomyosarcoma
What is the clinical presentation of embryonal rhabdomyosarcoma?
Grape-like mass protruding from vagina
What are the effects of diethylstilbestrol?
Inhibits müllerian differentiation; used to prevent spontaneous abortion
What is the precursor lesion for clear cell adenocarcinoma?
Vaginal adenosis: red superficial ulcerations
What female reproductive pathology is highly associated with exposure to diethylstilbestrol?
Clear cell adenocarcinoma in vagina/cervix
What anatomical abnormalities are associated with intrauterine diethylstilbestrol exposure?
Incompetent cervix
What is the most common cause of vaginal squamous cell carcinoma?
Extension of cervical squamous cell carcinoma
What comprises the cervix?
Endocervix and exocervix
What is the role of lactobacillus in the vaginal flora?
[Gram+ rod]
What is the most common site of squamous dysplasia and squamous cell carcinoma in the cervix?
Transitional zone
What is the most common cause of vaginal discharge?
Cervicitis
What is the most common finding in acute cervicitis?
Vaginal discharge
What is the most common cause of acute cervicitis?
C. trachomatis and N. gonorrhoeae account for >50% of cases
What causes follicular cervicitis?
C. trachomatis
What are reticulate bodies?
Produce elementary bodies, the infective particle of Chlamydia
What is opthalmia neonatorum?
Neonatal conjunctivitis contracted during delivery; vertical transmission of C. trachomatis, N. gonorrhoeae
What is the purpose of a cervical Pap smear?
Screen for dysplasia/cancer
What Pap smear finding indicates adequate estrogen?
Superficial squamous cells
What Pap smear finding indicates adequate progesterone?
Intermediate squamous cells
What Pap smear finding indicates lack of estrogen/progesterone?
Parabasal cells
What are the Pap smear findings in a normal nonpregnant female?
70% superficial squamous cells
What are the Pap smear findings in a normal pregnant female?
100% intermediate squamous cells
What are the Pap smear findings in an elderly female?
100% parabasal (atrophic); inflammatory cells
What are the Pap smear findings in a woman taking estrogen-only hormone replacement?
100% superficial squamous cells
What is the typical presentation of a cervical polyp?
Postcoital bleeding; vaginal discharge
Are cervical polyps cancerous?
Nonneoplastic; not precancerous
What are most cases of cervical intraepithelial neoplasia associated with?
HPV
What effect does HPV have on squamous cells?
Koilocytosis; clear halo containing a wrinkled, pyknotic nucleus
What is the primary complication of cervical dysplasia?
Precursor for squamous cell carcinoma
What is the classification of cervical intraepithelial neoplasia?
CIN I: mild
What is the average age of presentation for squamous cell carcinoma of the cervix?
~45 years
What are some general epidemiological features of cervical cancer?
Least common gynecologic cancer
What accounts for the decreased incidence and mortality of cervical cancer in the US?
Cervical pap smears
What is the most common sign of cervical cancer?
Abnormal vaginal bleeding
How does cervical cancer typically spread?
Spreads down and out
What is the most common cause of death in cervical cancer?
Renal failure
What are the steps in the sequence to menarche?
Breast budding
What is the most variable phase of the menstrual cycle?
Proliferative phase
What hormone mediates the proliferative phase of the menstrual cycle?
Estrogen
What hormonal changes lead to ovulation?
Estrogen surge → LH surge → ovulation
When does ovulation occur?
Between days 14 and 16 o the menstrual cycle
What is the best sign of ovulation?
Subnuclear vacuoles in endometrial cells
What is the least variable phase of the menstrual cycle?
Secretory phase
What hormone mediates the secretory phase of the menstrual cycle?
Progesterone
Where does fertilization typically occur?
Ampullary portion of fallopian tube
How long does it take for the fertilized egg to implant?
5 days
What is the Arias-Stella phenomenon?
Exaggerated secretory phase that occurs in pregnancy
What occurs in menses?
Drop in hormones initiates apoptosis
Why does vaginal bleeding occur in newborn girls?
Mother’s estrogen causes endometrial hyperplasia; sudden drop following delivery induces bleeding
What changes are stimulated by FSH?
Prepares follicle
In what stage of division are unstimulated follicles arrested?
Meiosis I prophase
What is the function of LH in the proliferative phase?
Synthesis of testosterone for conversion by aromatase into estradiol in granulosa cells
What occurs when a follicle is stimulated by LH?
Follicle progresses to meiosis II metaphase
What happens after fertilization?
Fertilized follicle develops into mature oocyte with 23 chromosomes
What is the role of LH in the secretory phase?
Synthesizes 17-OH-progesterone
What is hCG?
LH analogue; synthesized in syncytiotrophoblast lining chorionic villus in the placenta
What is the function of hCG?
Maintains corpus luteum of pregnancy for 8-10 weeks
What is the mechanism of oral contraceptive pills?
Low estrogen prevents LH surge and ovulation; progestins cause gland atrophy and inhibit LH
What is the primary estrogen of non-pregnant women?
Estradiol
When is primary estrogen of post-menopausal women?
Estrone
How is estrone produced?
Adrenal androstenedione → estrone
What is the estrogen of pregnancy?
Estriol
Where is estriol produced?
Fetal adrenal/liver
Where is DHEA-sulfate synthesized in women?
Almost exclusively synthesized in adrenal cortex
Where is testosterone synthesized in women?
Synthesized in ovary/adrenals
Where is sex hormone-binding globulin synthesized?
Liver
What is the relative affinity of sex hormone-binding globulin?
Higher binding affinity for testosterone than estrogen
What hematologic changes occur in pregnancy?
↑RBC mass/↑↑plasma volume = ↓Hb/RBC count
What renal changes occur in pregnancy?
↑↑plasma volume causes ↑GFR/CCr
What respiratory changes occur in pregnancy?
Respiratory alkalosis
What is the mechanism of respiratory alkalosis in pregnancy?
Estrogen/progesterone stimulation of respiratory center
How do cortisol and thyroxine levels change in pregnancy?
↑total serum T₄/cortisol; ↑in binding proteins, no change in free hormones
What is the definition of menopause?
No menses for 1 year after age 40
What is the average age of menopause?
51 years [genetically determined]
What are the symptoms of menopause?
Hot flushes
What testosterone changes occur in menopause?
↑testosterone levels in menopause; leads to ↑libido in some women
What are the laboratory findings in menopause?
↑FSH best marker
What is the clinical presentation of hirsutism?
Excess hair in normal hair-bearing areas
What features define virilization?
Hirsutism + male secondary sex characteristics
What is the underlying mechanism of hirsutism and virilization?
↑ androgens of ovarian, adrenal, or drug origin
What is the mechanism of ovarian-mediated hirsutism?
↑testosterone
What is the mechanism of adrenal-mediated hirsutism?
↑DHEA-S, testosterone
What is the most common cause of hirsutism?
Polycystic ovary syndrome
Polycystic ovary syndrome is associated with an increased incidence of which conditions?
Insulin-resistance
What is the key pathogenic factor underlying polycystic ovary syndrome?
LH/FSH ratio >3
What is the pathogenesis of polycystic ovary syndrome?
↑secretion of LH → follicular hyperthecosis (hyperplasia of ovarian theca cells) → ↑production of testosterone, androstenedione → hyperandrogenicity (e.g., hirsutism)
What are the effects of polycystic ovary syndrome?
Chronic anovulation
What is the mechanism of anovulation in polycystic ovary syndrome?
Less aromatization of androgens to estrogen
What happens to the excess androstenedione generated in polycystic ovary syndrome?
↑conversion of androstenedione to estrone → ↑endometrial hyperplasia/cancer, breast cancer risk
What are the clinical findings in polycystic ovary syndrome?
Oligomenorrhea
What are the laboratory findings in polycystic ovary syndrome?
LH/FSH ratio >3
What is the definition of menorrhagia?
Loss of blood >80 mL per period
What findings should raise suspicion for menorrhagia?
Staining sheets at night
What is the definition of dysmenorrhea?
Painful menses
What is the mechanism of primary dysmenorrhea?
Due to PGF₂α; ↑uterine contractions
What is the most common cause of secondary dysmenorrhea?
Endometriosis
What is the definition of dysfunctional uterine bleeding?
Abnormal bleeding unrelated to an anatomic cause
What is the most common cause of abnormal bleeding?
Menorrhagia
What characterizes hypomenorrhea?
Regular normal intervals with decreased blood flow
What characterizes metrorrhagia?
Irregular intervals with excessive flow and duration
What characterizes menometrorrhagia?
Irregular or excessive bleeding during menstruation and between periods
What characterizes oligomenorrhea?
Menses at intervals >35 days
What characterizes polymenorrhea?
Menses at intervals
When do most cases of dysfunctional uterine bleeding occur?
Menarche and perimenopausal period
What is the most common type of dysfunctional uterine bleeding?
Anovulatory dysfunctional uterine bleeding
What is the mechanism of anovulatory dysfunctional uterine bleeding?
Excessive estrogen stimulation; occurs at the extremes of reproductive life
What is the mechanism of ovulatory dysfunctional uterine bleeding?
Inadequate luteal phase; irregular shedding of the endometrium
What is the pathogenesis of inadequate luteal phase in ovulatory dysfunctional uterine bleeding?
Inadequate maturation of corpus luteum; delayed secretory phase due to ↓17-OH progesterone synthesis
What is the pathogenesis of irregular endometrial shedding in ovulatory dysfunctional uterine bleeding?
Persistent luteal phase with continued secretion of progesterone; mixture of proliferative/secretory gland
What is the definition of primary amenorrhea?
No menses by age 16
What is the most common cause of primary amenorrhea?
Constitutional delay
What is the definition of secondary amenorrhea?
No menses for >6 months
What is the most common cause of secondary amenorrhea?
Pregnancy
What hormonal findings are associated with hypothalamic/pituitary causes of amenorrhea?
↓FSH, LH, estrogen
What are some examples of hypothalamic/pituitary disorders causing amenorrhea?
Anorexia nervosa
What hormonal findings are associated with ovarian causes of amenorrhea?
↑FSH, LH; ↓estrogen
What syndrome should be suspected with the combined findings of primary amenorrhea with poor secondary sex characteristics?
Turner syndrome
What hormonal findings are associated with end-organ causes of amenorrhea?
Normal FSH, LH, estrogen
What are some examples of end-organ defects causing amenorrhea?
Imperforate hymen
What is Asherman syndrome?
Removal of stratum basalis by excessive curettage
What is acute endometritis?
Uterine infection following delivery or abortion
What is the most common pathogen associated with acute endometritis?
Group B streptococcus
What are the clinical findings in acute endometritis?
Fever
What pathogen causes infections associated with intrauterine devices?
Actinomyces
What is the key histological finding in chronic endometritis?
Plasma cells in biopsy
What is adenomyosis?
Functioning glands/stroma in myometrium
What are the clinical findings in adenomyosis?
Menorrhagia
What is endometriosis?
Functioning glands/stroma outside the confines of the uterus
What is the most common cause of endometriosis?
Reverse menses
What is the pathogenesis of endometriosis?
Reverse menses
What site is most commonly involved in endometriosis?
Ovaries
What is the clinical significance of the rectal pouch of Douglas?
Site for collection of blood, malignant cells, pus, endometrial implants
What is the triad of symptoms in endometriosis?
Dysmenorrhea
How can endometriosis be diagnosed and treated?
Laparoscopy
What are the implications of an endometrial polyp?
Common cause of menorrhagia; no risk of endometrial cancer
What is the pathogenesis of endometrial hyperplasia?
Prolonged estrogen stimulation
What are the common risk factors associated with endometrial hyperplasia?
Early menarche/late menopause
What type of endometrial hyperplasia has the greatest risk for endometrial cancer?
Atypical hyperplasia (glandular crowding and dysplastic epithelium)
What is the main clinical finding in endometrial hyperplasia?
Postmenopausal bleeding
What is the most common gynecologic cancer?
Endometrial carcinoma
What is the effect of oral contraceptives on cancer risk?
↓risk of endometrial cancer
What is the most common type of endometrial carcinoma?
Well-differentiated adenocarcinoma (vs papillary)
What is the characteristic spread of endometrial carcinoma?
Spreads down and out
What is the most common clinical finding in endometrial cancer?
Postmenopausal bleeding
What is the most common benign connective tissue tumor in women?
Leiomyoma
In which population are leiomyomas more common?
Blacks > whites
What are the clinical findings of leiomyomas?
Menorrhagia
What is the most common uterine sarcoma?
Leiomyosarcoma
What are the histological characteristics of leiomyosarcoma?
Atypical mitotic spindles; ↑mitosis
What gynecologic tumor is strongly associated with previous irradiation?
Carcinosarcoma (malignant mixed müllerian tumors)
What are hydatid cysts?
Cystic müllerian remnant; may undergo torsion
What is the most common cause of female infertility and ectopic pregnancy?
Pelvic inflammatory disease
What is the most common cause of pelvic inflammatory disease?
N. gonorrhoeae and C. trachomatis; both present in 45% of cases
What is one of the common findings of pelvic inflammatory disease?
Hydrosalpinx (tube fills with clear fluid after pus resorbs)
What is the pharmacologic treatment of pelvic inflammatory disease?
Ceftriaxone (for N. gonorrhoeae)
What occurs in salpingitis isthmica nodosa?
Tubal diverticulosis
What complications are associated with salpingitis isthmica nodosa?
Infertility
What is the most common cause of ectopic pregnancy?
Previous pelvic inflammatory disease
What risk factors are associated with ectopic pregnancy?
Pelvic inflammatory disease
What is the most common location of ectopic pregnancy?
Ampullary portion of fallopian tube
When does an ectopic pregnancy present?
Usually presents ~6 weeks after previous normal menses
What is the classic triad of symptoms associated with ectopic pregnancy?
Vaginal bleeding
What are the complications of ectopic pregnancy?
Intraperitoneal hemorrhage and shock
What term describes the presence of blood in the fallopian tube?
Hematosalpinx (usually due to ectopic pregnancy)
How can an ectopic pregnancy diagnosed?
hCG is the best screening test; vaginal ultrasound is the confirmatory test
What is the most common ovarian mass?
Follicular cyst (nonneoplastic)
What is the most common ovarian mass in pregnancy?
Corpus luteum cyst (nonneoplastic)
What causes oophoritis?
May be a complication of mumps or pelvic inflammatory disease
What are the clinical findings of stromal hyperthecosis?
Hirsutism/virilization
What age group is at highest risk for ovarian cancer?
Risk increases with age
What risk factors are associated with the development of surface-derived ovarian tumors?
Genetic factors
Patients with Turner syndrome are at increased risk for what neoplasm?
Dysgerminoma
OCPs/pregnancy are associated with decreased risk for what type of malignancy?
Surface-derived ovarian tumors
What is the most common group of ovarian tumors?
Surface-derived tumors
What is the most common ovarian cancer?
Serous cystadenocarcinoma
What are some key findings associated with serous cystadenocarcinoma?
Bilateral
What is a complication of malignant surface-derived ovarian cancers?
Commonly seed the abdominal cavity
What is the most common benign germ cell tumor?
Teratoma
What is the most common malignant germ cell tumor?
Dysgerminoma
What are sex cord-stromal tumors?
Hormone-producing tumors (estrogen/testosterone); most are benign
What are Krukenberg tumors?
Metastasis to ovaries with signet ring cells
What is the most common sign of ovarian cancer?
Abdominal enlargement due to fluid
What causes malignant ascites?
Seeding
What are the clinical signs of malignant ascites due to seeding?
Induration in rectal pouch
What should be suspected in a postmenopausal woman with palpable ovaries?
Ovarian cancer
What is a common site for ovarian metastasis?
Pleural cavity
What clinical findings are associated with cystic teratomas?
Torsion with infarction
What clinical findings are associated with sex cord-stromal tumors?
↑estrogen (granulosa cell)/↑androgens (Sertoli-Leydig cell)
What is the tumor marker for surface-derived ovarian tumors?
↑CA125
What covers the fetal surface of the placenta?
Chorionic plate
What is found on the maternal surface of the placenta?
Cotyledons
What is the function of chorionic villi?
Extract O₂ from maternal blood
What type of tissue lines the chorionic villi?
Trophoblast: made up of outer layer of syncytiotrophoblast (synthesizes hCG, HPL) and inner layer of cytotrophoblast
What is the function of human placental lactogen?
Anti-insulin activity; similar to human growth hormone
What forms the umbilical vein?
Vessels in chorionic villi
What structures are found within the umbilical cord?
Two arteries
What are the implications of a single umbilical artery?
Increased incidence of congenital anomalies
What is the most common cause of placental infection?
Ascending broup B streptococcus from vagina
What is the definition of funisitis?
Infection of the umbilical cord
What is the definition of placentitis?
Infection of the placenta
What is chorioamnionitis?
Infection in fetal membranes; danger of neonatal sepsis/meningitis
What is placenta previa?
Implantation over cervical os
What risk factor is associated with placenta previa?
Previous C-section
How does placenta previa present?
Painless vaginal bleeding
What is the appropriate management of placenta previa?
Diagnose by ultrasound
What causes abruptio placentae?
Retroplacental clot
What is the most common cause of late pregnancy bleeding?
Abruptio placentae
What is the greatest risk factor for abruptio placentae?
Hypertension
What is the triad of clinical findings in abruptio placentae?
Painful vaginal bleeding
What is the appropriate management of abruptio placentae?
No pelvic exam
What are the implications of placenta increta/percreta?
Implantation into muscle; danger of hemorrhage at delivery
What are the implications of velamentous insertion?
Cord inserts away from placental edge; danger of tearing vessels
What are the implications of an accessory placental lobe?
↑risk of hemorrhage if detached
What causes an enlarged placenta?
Rh hemolytic disease of newborn
What type of twins form a monochorionic placenta?
Identical twins from a single fertilized egg
What type of twins form a dichorionic placenta?
Identical or fraternal (separate fertilized eggs)
When does preeclampsia occur?
Usually occurs after the 20th week of pregnancy
What risk factors are associated with preeclampsia?
Young/advanced age
What is the pathogenesis of preeclampsia?
Placental hypoperfusion
What pathologic findings are associated with preeclampsia?
Hypertension
What is eclampsia?
Preeclampsia + seizures
What is the treatment for preeclampsia?
Delivery is the treatment of choice; methyldopa for hypertension
What is a hydatidiform mole?
Benign tumor in chorionic villus; look like grapes
What are the characteristics of a complete molar pregnancy?
All villi are neoplastic; dilated neoplastic villi with no fetal parts
What causes a complete molar pregnancy?
Fertilization of empty ovum by 46XX/XY sperm or two separate 23X/Y sperm
How does a complete molar pregnancy appear on ultrasound?
snowstorm appearance; too large for gestational age
What are the characteristics of a partial molar pregnancy?
Normal villi intermixed with neoplastic villi; fetal parts intermixed with neoplastic villi
What causes a partial molar pregnancy?
Fertilization of a 23X/Y ovum by two sperm
What clinical findings are associated with a partial molar pregnancy?
Incomplete/missed abortion
What is a choriocarcinoma?
Malignancy of trophoblastic tissue; no chorionic villi
What risk factors are associated with choriocarcinoma?
Complete mole > spontaneous abortion > normal pregnancy > partial mole
What are the common sites of metastasis associated with choriocarcinoma?
Lungs, vagina; lesions are hemorrhagic
What is the composition of amniotic fluid?
Predominantly fetal urine
Why does amniotic fluid cause “ferning” when dried on a glass slide?
High salt content
What are the causes of polyhydramnios?
Tracheoesophageal fistula
What is the main cause of oligohydramnios?
Juvenile polycystic kidney disease
What underlying defect is implicated by ↑AFP?
Open neural tube defect; inadequate folic acid before pregnancy
What underlying defect is implicated by ↓AFP?
Down syndrome
What is indicated by an L/S ratio >2?
Adequate surfactant
What factors influence surfactant synthesis?
↑ with glucocorticoids/thyroxine
What is the source of urine estriol in pregnancy?
Fetal adrenal gland/liver
What causes ↓estriol?
Sign of fetal-maternal-placental dysfunction
What triad of laboratory findings is associated with Down syndrome?
↓urine estriol
What is the most common location of breast cancer?
Upper outer quadrant
What effect does estrogen have on breast tissue?
Stimulates ductal/alveolar growth, fat, stroma
What effect does progesterone have on breast tissue?
Stimulates alveolar proliferation/lobule differentiation; breast swelling
What is the role of prolactin in lactation
Stimulates/maintains lactogenesis and secretion
What is the role of oxytocin in lactation?
Released by suckling; expulsion of milk into ducts
Where do outer quadrant breast cancers drain?
Axillary nodes
Where do inner quadrant breast cancers drain?
Internal mammary nodes
What is the most common physiologic cause of galactorrhea?
Mechanical stimulation of the nipple
What is the most common pathologic cause of galactorrhea?
Prolactinoma
What is the most common nonpituitary cause of galactorrhea?
Primary hypothyroidism: ↑TRH stimulates prolactin release
What drugs commonly cause galactorrhea?
Oral contraceptive pills
What pathologies cause bloody nipple discharge?
Intraductal papilloma
What causes purulent nipple discharge?
Acute mastitis during breast-feeding
What causes greenish nipple discharge?
Mammary duct ectasia
What is the most common cause of breast pain?
Fibrocystic change
What is Mondor disease?
Superficial thrombophlebitis overlying breast
What are some examples of benign calcifications in mammograms?
Popcorn calcifications
What is the most common breast mass in women
Fibrocystic change
How does fibrocystic change feel on breast examination?
Lumpy bumpy due to cysts and fibrosis
Sclerosing adenosis is associated with what finding on mammogram?
Often contain microcalcifications
What complication is associated with atypical ductal hyperplasia?
↑risk of breast cancer
How does mammary duct ectasia present?
Greenish brown nipple discharge; common in menopause
What is the presentation of traumatic fat necrosis?
Usually presents as a painless indurated mass; associated with trauma to breast tissue
What happens if a silicone breast implant ruptures?
Silicone produces foreign body giant cell reaction
What is the most common breast tumor in women
Fibroadenoma
What drug is highly associated with the development of fibroadenomas?
Cyclosporine; 50% of women taking cyclosporine post renal transplantation develop fibroadenomas
What is a fibroadenoma?
Benign tumor derived from stroma
What are the characteristics of a Phyllodes tumor?
Benign, borderline, or malignant stromal tumor; depends on stromal cellularity
What is the most common cause of bloody nipple discharge in women
Intraductal papilloma
What is the most common cancer in women?
Breast cancer
What is the most common breast mass in women >50 years old?
Breast cancer
What factors increase the risk for breast cancer?
Prolonged estrogen stimulation
What percent of breast cancers have a genetic basis?
What risk factors are associated with breast cancer?
Unopposed estrogen
What factors reduce the risk of breast cancer?
Breast-feeding
What are the clinical findings of breast cancer?
Painless mass; skin/nipple retraction
What is the purpose of mammography?
Screening to test for nonpalpable masses
What causes microcalcifications in breast tissue?
Ductal carcinoma in-situ
What are some features that can be used to distinguish malignant microcalcifications on mammography?
Clustered punctate, microlinear, or branching
Breast cancer is the most common source of metastasis in which two sites?
Lungs and bone
How can pain in bone metastasis be relieved?
Radiation
What determines the staging of breast cancer?
Extranodal spread has greater significance than nodal metastasis alone
Which node sampled in sentinel node biopsy?
Initial node draining the tumor
What receptor assay confers better prognosis for breast cancer?
Positive assay for estrogen and progesterone receptors (ERA-PRA)
What is the significance of ERBB2?
Oncogene; if positive in breast tissue, poor prognosis
What physical finding is caused by damage to the long thoracic nerve?
Winged scapula
What is the relative survival rate of breast conservation vs mastectomy?
Breast conservation therapy has similar survival rate as modified radical mastectomy
What is the definition of gynecomastia?
Benign glandular proliferation of male breast tissue due to estrogen stimulation
What are the sources of estrogen in males?
Peripheral aromatization of androgens
When does physiological gynecomastia occur?
Gynecomastia is normal in newborns, adolescence, and elderly
What is the most common pathologic cause of gynecomastia?
Cirrhosis (via hyperestrinism)
What are some genetic causes of gynecomastia?
Klinefelter syndrome
What drugs are associated with gynecomastia?
Spironolactone
What malignancy causes gynecomastia?
Choriocarcinoma of testis (via production of hCG)
What disorders cause gynecomastia via ↓androgens?
Leydig cell dysfunction
What risk factors are associated with the development of breast cancer in men?
Klinefelter syndrome