This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Endocrinology and breast, Subject name: Surgery
A 48-yr-old male alcoholic with cirrhosis has bilateral gynecomastia. Which physical findings has the same pathogenesis as gynecomastia? 
Select and explain. 
A. Caput medusae, B. Asterixis, C. Ascites, D. Spider angioma
D: Spider angioma
Answer: D: Spider angioma 
Explanation: Gynecomastia in male cirrhotics is caused by hyperestrinism secondary to the inability of the liver to metabolize estrogens. Hyperestrinism results in the development of female secondary sex characteristics, palmar erythema, spider angioma, and testicular atrophy caused by decreased testosterone.