During an examination of a 57-year old man, you note gynecomastia. Your next best action is what?

Request a mammogram.

Review the clients medication list for drugs that have gynecomastia as a side effect.

Request a breast biopsy.

Proceed with the examination, this is a normal part of the aging process.

Answer and Explanation

The Correct Answer is B

A.   While mammograms are commonly used to evaluate breast tissue in women, they are not typically used for men. In men, gynecomastia is usually evaluated with a physical exam and sometimes ultrasound rather than mammography. A mammogram might be ordered if there is a suspicion of breast cancer, but this is less common and not the first step in evaluating gynecomastia.
B.   This is a prudent and effective next step. Certain medications can cause gynecomastia as a side effect, including some antipsychotics, antidepressants, antiandrogens, and calcium channel blockers. Reviewing the medication list can help identify if the gynecomastia might be related to a drug the client is taking.
C.   A breast biopsy is an invasive procedure used to diagnose breast cancer or other conditions when there is a concern about a mass or abnormality. If gynecomastia is the only finding and there are no concerning features such as a palpable mass or other symptoms, a breast biopsy would not be the first step.
D.   While gynecomastia can occur as a normal part of aging, especially in older men due to hormonal changes, it is important to evaluate it thoroughly to rule out other causes. Simply dismissing it as a normal part of aging without further investigation might overlook an underlying condition or medication side effect.

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Correct Answer is A

Explanation

A. Scoliosis is characterized by an abnormal lateral curvature of the spine. This can result in an uneven shoulder height and an asymmetrical rib cage when viewed from the front or back. The spine may curve to the side, creating a noticeable "S" or "C" shape.
B. Lordosis, also known as hyperlordosis, is an excessive inward curvature of the lower back (lumbar spine). This condition makes the buttocks appear more prominent and the abdomen to protrude. The pelvis tilts forward, creating a pronounced curve in the lower back.
C. Pigeon chest, or pectus carinatum, is a condition where the chest protrudes outward, giving it a "pigeon-like" appearance. The sternum sticks out, creating a noticeable bulge in the center of the chest.

D. Kyphosis is characterized by an excessive outward curvature of the upper spine (thoracic spine), resulting in a hunchbacked or rounded appearance of the upper back. The back may appear rounded or hunched when viewed from the side.

A. Lying supine with arms at the sides. B. Sitting with the hands pushing into the hips. C. Lying supine with one arm elevated over her head. D. Learning forward with hands outstretched.

Correct Answer is C

Explanation

A. This position is useful for inspecting the overall shape and size of the breasts, but it may not be the best for detecting retractions.
B. This position can help identify changes in the breast tissue, but it may not be as effective as raising one arm overhead for detecting retractions.
C. Raising one arm over the head tenses the muscles in the breast and chest, which can make any retractions more visible. Retraction is often characterized by dimpling or pulling of the skin, which may be more noticeable when the breast tissue is taut.
D. This position can be helpful for examining the breasts for other abnormalities, but it may not be the best for detecting retractions.

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During an examination of a 57-year old man, you note gynecomastia. Your next best action is what?

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Naxlex Comprehensive Predictor Exams

Which abnormality is depicted in the image below?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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During an examination of a 57-year old man, you note gynecomastia. Your next best action is what?

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