Answer to Question 1
Correct Answer: 1
Any condition that increases estrogen activity or decreases testosterone production can contribute to gynecomastia. Conditions that increase estrogen activity include obesity, testicular tumors, liver disease, and adrenal carcinoma; conditions that decrease testosterone production include chronic illness such as tuberculosis or Hodgkin' disease, injury, and orchitis. Drugs such as digitalis, opiates, and chemotherapeutic agents are also associated with gynecomastia. Dismissing the patient's concerns is not therapeutic and until further evaluation is completed this could be potentially dangerous. Gynecomastia is usually bilateral. If it is unilateral, biopsy may be necessary to rule out breast cancer.
Answer to Question 2
Correct Answer: 1
Excessive smooth muscle contraction in benign prostatic hypertrophy (BPH) may be blocked with the alpha-adrenergic antagonists such as doxazosin mesylate (Cardura). This medication relieves obstruction and increases the flow of urine. It may cause orthostatic hypotension. The use of surgical intervention to manage BPH is not determined by monitoring blood pressure. The volume of urinary residual does not have bearing in this question. Finasteride (Proscar) does not impact blood pressure.