question

fibrocystic dz, fibroadenomas, intraductal papilloma, infxn:mastitis or breast abscess

answer

benign breast dz (lumps)

question

common in premenopausal women over 20y/o, pain, swelling, fluctuation in size, freq. bilateral, vary with menstrual cycle,

answer

fibrocystic breast dz

question

cyst fluid is clear straw colored, dark green, but if bloody needs a bx

answer

fibrocystic breast dz

question

benign neoplasm seen in young women within 20 yrs after puberty, minimal risk to breast cancer, dx with mammogram or US

answer

fibroadenoma

question

most common discrete mass in women <30y/o, enlarge during pregnancy and involute after menopause, typically1-3 cm,

answer

fibroadenoma

question

well encapsulated, smooth, firm, rubbery, mobile mass, mammogram and US show well circumscribed borders

answer

fibroadenoma

question

dx with core needle bx or repeat US and breast examination, excision if size or symptoms increase

answer

fibroadenoma

question

benign tumor within milk ducts that can lead to carcinoma in situ (DCIS), may present as breast lump, nodule on US or nipple discharge

answer

intraductal papilloma

question

MCC of bloody nipple d/c

answer

intraductal papilloma

question

appearance: mammogram will how mass or calcification, US: solid mass with a cyst, palpable lump or bloody nipple d/c

answer

intraductal papilloma

question

dx: US bx, stereotactic core bx, fine needle aspiration, wire directed excisional bx

answer

intraductal papilloma

question

paget's dz of breast, infxn (mastitis, breast abscess, fibrocystic dz, fibroadenomas, intraductal papilloma

answer

benign breast dz (pain with lump)

question

swelling, erythema, warmth, tenderness, induration of central or peripheral breast, purulent nipple d/c,

answer

mastitis (which and progress to breast abscess)

question

MC staph aureaus but consider MRSA

answer

mastitis (which and progress to breast abscess)

question

blister or ulcer in breast you want to think what?

answer

paget's dz (could be malignant)

question

persistent scaling, eczematous or ulcerating lesion involving the nipple, areolar complex

answer

paget's dz (could be malignant)

question

presence of malignant intraepithelial adenocarcinoma cells within epidermis of nipple

answer

paget's dz (could be malignant)

question

galactorrhea or gynecomastia

answer

benign breast complaints

question

d/c of milk or milk like secretion past 6 mo, is often idiopathic or from trauma, nipple stimulation, hypothyroidism or hyperprolactinemia

answer

galactorrhea

question

benign enlargment of male breast resulting from proliferation of glandular tissue, increased breast sensitivty to estrogen level

answer

gynecomastia

question

causes: steroid abuse, obesity, genetic d/o, chronic liver dz, hyperthyroid, meds like diuretic, estrogens, INH, marijuana, EtOH

answer

gynecomastia

question

fat depostion without glandular proliferation, often seen in obese men

answer

pseudogynecomastia

question

mass, spiculated mass, mass, architectural distortion, calcification mass, calcification

answer

mammogram results

question

cysts, solids, masses

answer

US results

question

which dx tool has can see the smallest nodule or mass

answer

MRI

question

use for cysts, solid lumps or masses, can't distinguish between invasive and non invasive

answer

fine needle aspiration

question

needle placed in mass an 3-5 cores are tken in formatlin, invasion can be deteremined

answer

core needle bx

question

large volume of tissue studied, visually verifty sampling and usually is dx

answer

US guided bx

question

use for bx of calcifications or non palpable masses or excision of calcifications

answer

wire directed excisional bx

question

minimally invasive, used for nonpalpable mammographic suspicous lesions

answer

stereotactic core bx

question

RF: female, over 50, white, no kids, early menarche, late menopause, first degree relative, excessive ETOH

answer

breast cancer

question

risk reduction: exercise, maintain normal wt, breastfeed, diet of fruits and veggies, avoid smoking and minimize ETOH, prophylactic dx

answer

breast cancer

question

malignancy usually has no pain, nipple inversion is underlying sign, slit line nipple retraction

answer

breast cancer

question

nipple discharge can be bilateral or unilateral that involve multiple ducts and assoc with mass

answer

breast cancer

question

large single tumor with extensive lymph node involement, edema, erythema, pitting, look like an infxn

answer

breast cancer

question

MC types are invasive ductal and invasive lobular

answer

breast cancer

question

<1%, RF: klinefelter's syndrome, chronic liver d/o, BRCA 2 mutation

answer

male breast cancer

question

tx can cause lymphedema, long thoracic nerve injury (winging of scapula), thoracodorsal nerve injury, hematoma

answer

breast cancer

question

start 6 weeks after surgery id not receiving chemo, start after chemo if needed, SE: fatigue, hyperpigmentation, desquamation, breast firmness or heaviness

answer

radiation therapy for breast cancer

question

used for >1 cm invasive or <1 cm high grade invasive, if lymph node metastaic breast cancer is seen, hair loss, stomatitis, mucositis, wt gain, leukopenia

answer

chemo for breast cancer

question

cardiomyopathy from adriamycin, hemorrhagic cystitis from cyclophosphamide, numbness or paresthesias from 5 fluorouracil, hypersensitivity from taxanes

answer

drug specific toxicity from chemo

question

tamoxifen, for estrogen receptor +, invasive breast cancer, ductal carcinoma in situ, pre and post meno pausal women, raloxifene--used in pts with elevated breast cancer risk

answer

selective estrogen receptor modulators (SERM)

question

help preserve bone mineral density, for thromboembolic events, endometrial cancer

answer

SERM

question

blocks aromatase enzymes in adrenal gland, ovaries, fat, muscle, liver--given to post menopausal women only for invasive breast cancer fewer side effects and more effective than tamoxifen

answer

aromatase inhibitors

question

anastrazole, letrozole, exemestane

answer

aromatase inhibitors

question

what increases risk for thromboembolic events

answer

tamoxifen and raloxifen

question

non invasive breast cancer

answer

DCIS, LCIS (lobular carcinoma in situ)

question

normal physical exam, confined to duct system and progress to invasive, lesion are multifocal

answer

DCIS

question

arise from lobules, terminal ducts, incidental finding from breast bx, multifocal or bilateral and can develop invasive Ca in either breast

answer

LCIS

question

oligo or anovulation, hyperandrogenism or polycystic ovaries

answer

PCOS

question

MCC of infertility in women

answer

PCOS

question

T/F: do all women with PCOS have polycystic ovaries

answer

false

question

T/F: do all women with polycystic ovaries have PCOS

answer

false

question

what is most potent circulating androgen

answer

testosterone

question

T/F: is PCOS from high concentration of androgen

answer

true

question

T/F: is there a low sex hormone binding globulin in pts with PCOS

answer

true

question

immediate precursor to testosterone ? and what stimulates the thecal secretion of this androgen?

answer

androstenedione and LH stimulates the thecal secretion

question

ovarian androgen production may increase as result of what?

answer

increased thecal cells, increase LH stimulation, hyperinsulinemia assoc iwth LH, increase expression of LH receptor

question

estrogen levels are normal but progesterone is low and other androgens are high

answer

PCOS

question

if progesterone is low what are women at risk of

answer

heavy menses and endometrial hyperplasia

question

infertilty, hirsutism, acne, obesity, menstrual irregularity, ovarian enlargement, acanthosis nigricans

answer

PCOS

question

hCG, TSH, PRL, then check hormone levels, then fasting insuline, lipid panel or pelvic US if needed

answer

PCOS

question

moderate hirsutism you want to check the DHEA -S to r/o androgen secreting tumor

answer

PCOS

question

string of pearls on US

answer

PCOS

question

diabetes, hyperlipidemia, obesity, HTN, eating d/o, sleep apnea

answer

PCOS assoc d/o

question

rhythm, caution during ovulation times

answer

fertility awareness method

question

checking secretions to make sure you don't have any

answer

2 day method

question

for breastfeeding women, used for first 6 mo, reduces GnRH, LH, and FSH

answer

lactational amenorrhea method

question

assoc with UTI, BV and yeast, insert 6 hr prior to coitus and remove 6-24 after

answer

diaphragm

question

successful fitting is critical, leave for 48 hrs and must leave for at least 6 hrs

answer

cervical cap

question

can be left in place and repeated use for up to 24 hrs

answer

the sponge

question

CI: severe cirrhosis, pregnant, DVT/PE, heart problems, migraine with aura, SLE

answer

contraceptives

question

what reduces effectiveness of COC

answer

rifampin, phenytoin, phenobarbital, carbamzepaine, topriramate, st john's wort, griseofulvin

question

can xray

answer

nexplanon

question

5 rods

answer

norplant

question

1 rod

answer

implanon

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