Gynaecomastia in PACES

This is a man !

The most important tool in PACES is Inspection.

However to differentiate a pass from a fail involves preparing for the exam and of course luck which is difficult to change except by praying hard for the exam. For the former, pls remember that the time for the cases are short and most that comes out from our mouth has been prepared before the exam

So, if you see this picture, always remember which station you are

Nobody will miss the gynaecomastia in the above man

Station 1 : Abdomen - Cirrhosis of liver

Station 1 - Resiratory - Bronchogenic carcinoma

Station 3 : Cardiovascular - Drugs (spironolactone/digoxin)

Station 3 : Neurology - Myotonic dystrophy

Station 5 : Endocrine - Klinefelter's syndrome

I know there are other causes of gynaecomastia such as adrenal... but my mentor (eMRCPian) once told me, always think PACES way when you are going for a PACES exam !!

So, the above patient has gynaecomastia from Klinefelter's syndrome, look for other signs of Klinefelter.

Written by Wuchereria