An 18-Year-Old Man Comes to the Physician with Bilateral Breast

question 382

Multiple Choice

An 18-year-old man comes to the physician with bilateral breast enlargement.  He has not seen a physician for the past 6 years.  He says that his puberty was "somewhat delayed."  The patient has no past medical problems and takes no medications.  He does not use tobacco, alcohol, or illicit drugs.  He has not used any "steroids" to build muscle.
The patient is 6' 2" (188 cm) tall and weighs 187 lbs (85 kg) .  He has sparse facial hair.  His axillary and pubic hair is normal.  He has Stage 3 bilateral gynecomastia without any mass or nipple discharge.  Visual fields are normal on confrontation.  The testes are firm and small (8 mL) .
Laboratory evaluation shows normal hematocrit and basic metabolic profile.  Serum luteinizing and follicle-stimulating hormones are elevated and testosterone is low.  Serum prolactin and thyroid-stimulating hormone are normal.
The patient is at highest risk for a malignancy at which of the following sites?

• A)Adrenal glands
• B)Breast
• C)Pancreas
• D)Prostate
• E)Thyroid gland

Explain the structure and function of enzymes, including factors affecting enzyme activity and denaturation.

Understand the regulatory mechanisms of enzyme activity within a cell, including gene expression and inhibitor effects.

Describe the processes of oxidation and reduction, and their relevance to cellular metabolism.

Identify causes of lactose intolerance related to enzyme deficiency.

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Definitions:

Nonverbal Cues

Forms of communication without using words, including gestures, facial expressions, and body language, that convey messages and emotions.

Untrained Listener

An individual who lacks the skills or experience to effectively understand and interpret spoken information, particularly in complex or technical contexts.

Levels Of Listening

Various degrees of attention and engagement that a listener can exhibit, affecting the effectiveness of communication.

Probing Questions

Inquisitive questions designed to gain deeper insights into a respondent's thoughts, feelings, or behavior.