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MCQ – 68247

Question

Cause of Condition of a Male shown in the photograph is 
A.

 Klinefelter’s syndrome 

B.

 Spironolactone 

C.

Pituitary Tumor

D.

All of the above

Show Answer

Correct Answer � D

Explanation

Ans is D All of the above

The condition shown in the image is Gynaecomastia

Gynecomastia

  • It results from an altered estrogen-androgen balance, in favor of estrogen, or from increased breast sensitivity to a normal circulating estrogen level.

Conditions associated with gynecomastia:

  • Klinefelter syndrome
  • Congenital anorchia
  • Testicular trauma
  • Viral orchitis
  • Kallmann syndrome
  • Pituitary tumors or abnormalities such as the ones that lead to either hypersecretion or hyposecretion of LH
  • Malignancies that increase the serum level of hCG (eg, large cell lung cancer, gastric carcinoma, renal cell carcinoma, hepatoma)
  • Renal failure
  • Hyperthyroidism: Gynecomastia seen with hyperthyroidism is due to increased aromatase activity and increased levels of SHBG.
  • Malnutrition: Gynecomastia seen with malnutrition and starvation is probably due to reduced gonadotropin and testosterone levels relative to estrogen
  • Androgen insensitivity syndrome
  • Aromatase excess syndrome.

Drugs associated with Gynecomastia:
Antiandrogen/inhibitors of androgen synthesis are as follows:

  • Cyproterone acetate
  • Flutamide, bicalutamide, nilutamide
  • Ketoconazole
  • Spironolactone

Cancer/chemotherapeutic drugs are as follows:

  • Alkylating agents
  • Methotrexate
  • Vinca alkaloids
  • Imatinib

Cardiac and antihypertensive medications are as follows:

  • Calcium channel blockers (verapamil, nifedipine, diltiazem)
  • ACE Inhibitors (captopril, enalapril)
  • Digoxin
  • Alpha-blockers
  • Amiodarone
  • Methyldopa
  • Reserpine
  • Nitrates

Hormones are as follows:

  • Androgens
  • Anabolic steroids
  • Estrogens
  • Growth hormones
  • Chorionic gonadotropin

Psychoactive drugs are as follows:

  • Haloperidol
  • Diazepam
  • Tricyclic antidepressants
  • Haloperidol
  • Phenothiazines

Drugs for infectious diseases are as follows:

  • Antiretroviral therapy for HIV/AIDS (eg, indinavir)
  • Isoniazid
  • Ethionamide
  • Griseofulvin
  • Minocycline
  • Metronidazole
  • Ketoconazole

Drugs of abuse are as follows:

  • Amphetamines
  • Heroin
  • Methadone
  • Alcohol
  • Marijuana

Others are as follows:

  • Theophylline
  • Omeprazole
  • Auranofin
  • Diethylpropion
  • Domperidone
  • Penicillamine
  • Sulindac
  • Heparin
  • Methotrexate

Management:

  • Medical: Clomiphene, Tamoxifen, Danazol
  • Surgical: Reduction Mammoplasty
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