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NBME 15 Answers

nbme15/Block 3/Question#43 (6.1 difficulty score)
An 18-year-old man is brought to the ...
Inquiry about a history of anabolic steroid use🔍

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submitted by andro(170),

The question essentially wants you to make a distinction between Pubertal Gynecomastia and Pathological Gynecomastia

Pubertal gynecomastia

  1. may be unilateral or bilateral
  2. tender or nontender
  3. found in 50 % of adolescents and typically resolves by the age of 17 , and as such patients require little more than reassurance

This Patient however is already above the age of 17( rule out reassurance !) Of the possible causes of pathological gynecomastia , anabolic steroid use is a very likely option based on the description provided

trazobone  See i assumed this was a “how to be a more empathetic physician” question, so i said reassurance. But i guess not putting reassurance makes sense bc it implies everything is normal +1  
cheesetouch  @Trazobone I think it's just one of those "suspect everyone until proven trustworthy/otherwise" questions :P +1