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NBME 15 Answers

nbme15/Block 3/Question#43 (reveal difficulty score)
An 18-year-old man is brought to the ...
Inquiry about a history of anabolic steroid use ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +1  upvote downvote
submitted by โˆ—andro(269)
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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

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trazobone  See i assumed this was a โ€œhow to be a more empathetic physicianโ€ question, so i said reassurance. But i guess not putting reassurance makes sense bc it implies everything is normal +6
cheesetouch  @Trazobone I think it's just one of those "suspect everyone until proven trustworthy/otherwise" questions :P +1



 +0  upvote downvote
submitted by โˆ—prostar(22)
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The reason why it is pathological gynecomastia is he has obvious signs pointing to steroid abuse.

1.enlarged breast

2.extremely muscular

3.sports team(on Step 1 questions)

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