Gynaecomastia Flashcards
1
Q
What drugs can cause gynecomastia?
A
- Spironolactone (most common drug cause)
- Cimetidine
- Digoxin
- Cannabis
- Finasteride
- Gonadorelin analogues e.g. Goserelin, buserelin
- Oestrogens
- Anabolic steroids
2
Q
What are some physiological causes of gynecomastia?
A
- Physiological: normal in puberty
- Syndromes with androgen deficiency: Kallman’s, Klinefelter’s
- Testicular failure: e.g. mumps
- Liver disease
- Testicular cancer e.g. Non-seminomatous secreting hCG
- Ectopic tumour secretion
- Hyperthyroidism
- Haemodialysis
3
Q
What are some very rare causes of gynecomastia?
A
- Tricyclics
- Isoniazid
- CCBs
- Heroin
- Busulfan
- Methyldopa
4
Q
What investigations should be done in new onset gynecomastia?
A
- Hormone profile
- Thyroid function
- Liver function
- Renal function
5
Q
If there is unilateral gynecomastia or unilateral change in existing gynecomastia, what should be done?
A
Refer to exclude breast cancer
6
Q
If a patient is thought to have Klinefelter’s syndrome, what is the next step in management?
A
Refer to a geneticist & if considering having children they may need referral to the fertility clinic once diagnosis is confirmed.
