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Repro > 04b: The Breast > Flashcards

04b: The Breast Flashcards

1
Q

T/F: Progesterone plays role in pubertal breast development.

A

True, but only AFTER menses

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2
Q

List the hormones that play role in pubertal breast development

A
  1. Estrogen, progesterone
  2. GH
  3. Prolactin
  4. Adrenal steroids
  5. Insulin
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3
Q

Early pregnancy: (X) hormone(s) causes (Y) changes in breast tissue.

A 
X = beta-hCG
Y = alveolar development
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4
Q

Late pregnancy: (X) hormone(s) causes (Y) changes in breast tissue.

A 
X = prolactin, E, P, GH, glucocorticoids, insulin
Y = secretory differentiation (increase number of glands)
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5
Q

Colostrum synthesis/accumulation begins in (early/late) pregnancy. What are the components of colostrum?

A

Late (secretory differentiation);

Lactose, milk proteins (casein, whey, a-lactalbumin), IgG, IgA

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6
Q

Maternal benefits to breastfeeding: decreased risk for which disease(s)?

A

Breast and ovarian cancer and DM II

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7
Q

Lactation is regulated by (nervous/endocrine) system.

A

Both!

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8
Q

Lactation: Suckling triggers (X) which stimulates (Y).

A 
X = 4-6th intercostal n (signal travels up SC)
Y = anterior pit (prolactin secretion) and post pit (oxytocin secretion)
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9
Q

List some short-term maternal benefits of breastfeeding.

A
  1. Decrease post-partum blood loss
  2. Weight loss
  3. Prolongs post-partum anovulation (high prolactin)
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10
Q

Direct benefits of breastfeeding on infant.

A

Decreased risk of illness (diarrhea, U/LRT infections, otitis media, UTIs)

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11
Q

Long-term benefits of breastfeeding on infant.

A

Decreases risk of:

Acute illnesses, obesity, allergies, GI infections, leukemia, DM I

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12
Q

Recommended length of breastfeeding.

A

At least 6 mo exclusively; then up to 1 year afterwards non-exclusively

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13
Q

T/F: HIV positive mothers cannot breastfeed unless they are on antiretroviral meds.

A

False - can’t breast feed, even if on meds

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14
Q

29 yo 2-day postpartum woman presents with swollen, lumpy, tender breasts. She reports that she has been breastfeeding her newborn. What is the likely cause?

A

Engorgement (baby isn’t latching adequately; edema and accumulated milk)

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15
Q

29 yo postpartum woman presents with swollen, lumpy, tender breasts. She reports that she has been breastfeeding her 7 month-old child. What is the likely cause?

A

Engorgement (likely due to weaning kid off breastmilk and producing more than he/she needs)

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16
Q

Breastfeeding: Rx for engorgement

A

Empty breasts (more feeding/pumping) and cool/warm compress

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17
Q

29 yo postpartum woman presents with swollen, erythematous, tender R breast and fever of 102o. She reports that she has been breastfeeding her 3 month-old child. What is the likely cause?

A

Mastitis (due to abrasion/cut from breastfeeding)

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18
Q

Most common organisms that cause mastitis:

A
  1. S. aureus
  2. Strep
  3. E. coli
19
Q

Mastitis Rx:

A
  1. Antibiotics (dicloxicillin, keflex, clindamycin)
  2. NSAIDs
  3. Keep breast feeding to empty breast
20
Q

1% of breastfeeding women may develop (X) complication from mastitis. What’s the Rx?

A

X = abscess

Serial drainage with GS/culture, along with antibiotics

21
Q

T/F: Non-proliferative breast lesions do not increase risk for breast cancer.

A

True

22
Q

T/F: Proliferative breast lesions without atypia do not increase risk for breast cancer.

A

False - some may

23
Q

Which imaging modalities would you use to evaluate breast lump in 25 yo woman?

A

Ultrasound (if between ages 21-30);

Note: Add mammogram if patient over age of 30

24
Q

Breast imaging rating: BIRADS (X) for lump that’s highly suggestive of malignancy. Next step is (Y).

A 
X = 5
Y = biopsy
25
Q

Breast imaging rating: BIRADS (X) for lump that’s benign. Next step is (Y).

A 
X = 2
Y = annual follow-up
26
Q

Breast imaging rating: lump is BIRADS 3. What’s the next step?

A

Probably benign, but short interval (6 mo) repeat imaging recommended

27
Q

Breast imaging rating: lump is BIRADS 4. What’s the next step?

A

Suspicious abnormality;

Biopsy should be considered

28
Q

Pt with proven breast malignancy undergoes imaging to stage/evaluate cancer after round of chemo. She would be placed in BIRADS (X).

A

X = 6

29
Q

Nipple discharge: which characteristics make it concerning for cancer?

A
  1. Bloody/purulent
  2. Unilateral
  3. Spontaneous
  4. Breast mass
  5. Woman over 40
30
Q

Pt presents with L nipple discharge. On ultrasound, you see fluid-filled duct with extensions/growths extending into lumen. Likely diagnosis is (X) and Rx is (Y).

A 
X = intraductal papilloma (common cause of unilateral nipple discharge)
Y = excision
31
Q

T/F: Intraductal papilloma is cancer.

A

F - but increases risk of cancer

32
Q

What are some peripheral causes of galactorrhea?

A

Nerve stimulation!

  1. Shingles (activating 4-6th intercostal nerve)
  2. Poorly fitting bra
  3. Nipple stimulation
33
Q

T/F: One risk of mammography is radiation exposure.

A

False - very low dose that does not increase risk of cancer

34
Q

Rx GOALS of premature ovarian failure includes:

A
  1. Psychosocial support
  2. Prevent osteoporosis (HRT, Ca, vit D, exercise)
  3. Yearly screening for endocrine abnormalities (hypothyroid, adrenal insuff)
  4. Contraception to prevent spontaneous conception
  5. Fertility (IVF)
35
Q

Physiology of menopause: what’s the first step?

A

Follicular depletion in ovary

36
Q

Menopause: follicular depletion causes (rise/fall) in (X) levels, which causes (rise/fall) in (Y) levels.

A

Fall
X = inhibin B
Rise
Y = FSH (fluctuates)

37
Q

Best Rx hot-flashes/vasomotor Sx in peri-menopausal woman.

A

Estrogen (short duration, low dose; give with progestin if uterus present)

38
Q

T/F: Female sexual dysfunction is more common with increased age (ex: 65 y or older).

A

False - more common in 45-64 yo women (likely due to menopause)

39
Q

List the four forms/complaints that can cause F sex dysfunction.

A
  1. Lack of sex desire
  2. Impaired arousal
  3. Inability to orgasm
  4. Pain
40
Q

T/F: Lab evaluation is not useful to F sex dysfunction.

A

True

41
Q

First FDA-approved drug for F sex dysfunction:

A

Flibanserin

42
Q

Flibanserin MOA and side effects.

A

Unknown (maybe impacting DA and SA neurotransmitters?)

Hypotension, syncope

43
Q

T/F: Flibanserin has been shown to be effective in up to 60% of women.

A

False - only 10%

44
Q

When prescribing your 50 yo F patient Flibanserin, it’s important that she takes it every (X) hours for (Y) weeks before it takes effect. She should also avoid (Z).

A 
X = 24y (daily)
Y = 4-8
Z = alcohol

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