Aj gynecomastia 15 aug 2011

Gynecomastia PROF:AKMAL JAMAL FCPS;FRCSEd: 13 AUG 2011

Definition of Gynecomastia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hormonal control of breast development ,[object Object],[object Object],[object Object],[object Object],[object Object]

Physiological vs pathological gynecomastia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

diagnosis of gynecomastia may be made ,[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Simon classification of gynecomastia Grade Enlargement Skin excess I small absent IIA moderate absent IIB moderate present III large present

Prevalence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Glandular Proliferation Androgen Exposure Estrogen Exposure Balance T &E2 =T/E2 Physiopathology of Gynecomastia

Pathophysiologic Causes for Gynecomastia ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Physiopathology of Gynecomastia Estrogen Exposure: 1- Excess of Production: Tumors Aromatization(age,obesity) 2-Exogenous E2 : E2 Aromatizable E2 3- Excess of Free E2 Thyrotoxicosis-Drugs(SHBG)

Absolute increase in free estrogen ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Decreased endogenous free androgens ,[object Object],[object Object],[object Object],[object Object],[object Object]

Aromatization Inhibitory Estrogens 5 α - androgens Androgens 5 α - reduction N Aromatization of Androgens

Etiologies of Gynecomastia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],10-25% 25% 25% 8% 8% 3% 2% 1.5% 1%

Gynecomastia and Thyrotoxicosis ,[object Object],[object Object],[object Object],[object Object],* wide range probably indicates differences in examining technique

Drugs associated with Gynecomastia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Estrogen Exposure: 1- Excess of Production: HCG Aromatizable Androgens 2-Exogenous E2: E2 Digoxin Marijuana 3- Excess of Free E2 Spirolactone Aromatizable E2 ACE,CCB ??

Specific Pathogeneses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Specific Pathogeneses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Specific Pathogeneses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Specific Pathogeneses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Evaluation ,[object Object],[object Object]

Candidates needing evaluation ,[object Object],[object Object],[object Object],[object Object]

Candidates not requiring evaluation ,[object Object],[object Object],[object Object],[object Object]

Work-up ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Work-up ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Examination : local ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Laboratory Studies

Work-up ,[object Object],[object Object],[object Object]

Biochemical investigations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],proceed further according to lead

Treatment Options ,[object Object],[object Object],[object Object]

A major factor that should influence the initial choice of therapy ,[object Object],[object Object],[object Object]

Treatments ,[object Object],[object Object],[object Object],[object Object]

Treatments ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Androgens ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Antiestrogens ,[object Object],[object Object],[object Object],[object Object],[object Object]

Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Aj gynecomastia 15 aug 2011

Empfohlen

Empfohlen

Weitere ähnliche Inhalte

Was ist angesagt?

Was ist angesagt? (20)

Ähnlich wie Aj gynecomastia 15 aug 2011

Ähnlich wie Aj gynecomastia 15 aug 2011 (20)

Kürzlich hochgeladen

Kürzlich hochgeladen (20)

Aj gynecomastia 15 aug 2011