A previously healthy 54-year-old man comes to the physician for a 3-month history of difficulty achieving an erection. He has drunk 2 pints of whisky daily for the past 20 years. Physical exam shows scleral icterus and spider angiomata. There is gynecomastia. Abdominal examination shows a prominent umbilical venous pattern and ascites. Which of the following is the most likely cause of this patient’s gynecomastia?
Excess estrogen production by the adrenal glands
Excess estrogen production by the testes
Excess testosterone degradation by the liver
Failure of estrogen degradation by the liver
Failure of liver to produce sex hormone binding globulin
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Cut-to-the-chase Answer (0:26):
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HY USMLE Answer (2:12):
