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EM Tintinallis > 104 105 Breast Disorders and complications of gym procedures > Flashcards

104 105 Breast Disorders and complications of gym procedures Flashcards

1
Q

Lymphatic drainage of the Breast is primarily to the

A

Axilla

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2
Q

What are the systemic diseases associated with hyperprolactinemia

A

Chronic renal failure (diminished capacity to clear circulating prolactin), hypothyroidism, hypercortisolism, acromegaly

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3
Q

When do breasts normally in gorge from pregnancy,?

A

On the 3rd to 5th postpartum day

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4
Q

Association between nipple pain and topical nefedipime

A

Reynards phenomenon can cause nipple pain in response to this medication

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5
Q

When does perpeural mastitis occur

A

Commonly present in the second postpartum week due to milk stasis and retrograde infection

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6
Q

Most common pathogens associated with mastitis

A

Staff aureus and 40% of cases and E. coli and strep are also common species consider MRI essay with abscess

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7
Q

At what point can you give lactating mothers Bactrim

A

On the infant is greater than two months old

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8
Q

How often do breast abscesses complicate mastitis

A

Only 3% of cases

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9
Q

Initial first line treatment for breast abscess

A

Ultrasound guided drainage

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10
Q

Treatment for mastitis with abscess

A

Add clindamycin or oral cephalosporin for MOur essay, Vanco myosin is also a good choice for septic patients or inpatient hospitalization

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11
Q

In addition to mastitis what other conditions do you have to exclude

A

The car is inflammatory breast condition such as cellulitis, hidradenitis super Teva, inflammatory breast cancer

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12
Q

When is acute mastitis or breast abscess and a non-lactating woman most commonly seen

A

Diabetics, smokers, obesity.

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13
Q

What others tests should you consider in a patient with mastitis

A

Follow up mammography for patients older than 30 years old And after the acute infection phase has resolved

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14
Q

When should you consider inflammatory breast cancer In a patient with mastitis

A

If there is not an initial good response antibiotics or breast cellulitis or abscess fails to completely resolve

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15
Q

Characteristics of nipple discharge that is not suggestive of cancer

A

Bilateral, occurs with a nipple manipulation, and can be expressed from several ducts.

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16
Q

When is nipple discharge concerning for cancer

A

Originates in a single breast, emanates from a single duct, and it’s clear, the pink, bloody, or serosanguineous

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17
Q

Epidemiology and features of intraductal papilloma

A

Unilateral bloody nipple discharge in women from 20 to 40 years old

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18
Q

What is Mondor’s disease

A

It is a superficial thrombophlebitis of the breast that presents with a painful palpable quarter mass in the superficial tissue.

19
Q

Treatment for Mondor’s disease

A

NSAIDs and possibly low molecular weight heparin after a hematology consultation

20
Q

If you suspect a benign breast mass, what physical exam shines should prompt surgical surgical referral

A

Lymphadenopathy, skin ulceration, mass fixation to the chest wall, fixed axillary notes, in the presence of ipsilateral arm Adema

21
Q

How much blood count extravasate into the traumatized breast parenchyma?

A

Up to 1.5 L

22
Q

Rate of breast implant complications

A

About 6%.

23
Q

Treatment for breast implant complications/infection

A

For sick or impatience, use vancomycin with gentamicin. For outpatient treatment tetracycline and doxycycline recommended

24
Q

Silicone versus saline implant rupture

A

Celine is clearly detected in physical exam because it becomes deflated this is typically painless and can be done outpatient follow-up. Silicone reps is more difficult to diagnose and have to be done ultrasound and MRI. The treatment is surgical but patient should be assured that there’s no danger from silicon leakage

25
Q

Postoperative fever timeline

A

Versus water occurring 3 to 5 days postop, Then is walking on postoperative day four to six, wound usually seven days after surgery

26
Q

And patients undergoing fertility treatment why Do you defer the pelvic exam to the gynecologist

A

Possibility of rupturing and large ovarian follicles

27
Q

Air from insufflated carbon dioxide and laparoscopic surgery should be completely absorbed by what day

A

Postoperative day number three

28
Q

What should be the first thing on your mind with patients that have greater than expected pain after laparoscopic surgery

A

It is about Bowel injury until proven otherwise

29
Q

What is the most easily miss complication of laparoscopic surgery

A

A thermal injury

30
Q

What are the main complications of laparoscopic surgery

A

Bal injury, thermal injury, vascular injury, urinary tract injuries, such as fistula, incisional hernia’s in dehiscence, and finally wound infection.

31
Q

What is the most feared complication of using carbon dioxide gas to for distention during laparoscopic

A

Gas embolism

32
Q

Management of patients with vaginal cuff cellulitis or pelvic abscess

A

Admit patients for parenteral antibiotics and possible drainage by interventional radiology or colpotomy

33
Q

What is the classic patient description when they describe dehiscence or evisceration?

A

A pop or tearing sensation

34
Q

Timeline for dehiscence of abdominal surgeries and vaginal cuff dehiscence

A

Dehiscence after down the surgeries happens between postoperative days five and eight while vaginal cavity has occurs approximately 1.5 to 3.5 months after hysterectomy

35
Q

Management of the essence or evisceration

A

Cover the abdomen with moist sterile towel that support the dressing the tape to prevent further got extrusion

36
Q

When do you suspect a ureteral injury after surgery

A

And women who develop flank pain

37
Q

When do vesicovaginal fistula’s normally happen after surgery

A

10 to 14 days after with watery vaginal discharge

38
Q

How to confirm the diagnosis of vesicovaginal fistula?

A

Inserting a cotton tampon into the vagina and then instilling methylene blue or indigo Carmen die be a trans urethral catheter if the tampon stands blue official is present if ureterovaginal fistula is suspected, rule out by injecting 5 mL of the die IV

39
Q

Prevalence of postoperative DVT

A

11 to 25%

40
Q

How to treat septic pelvic thrombophlebitis

A

Anticoagulation and parenteral antibiotics

41
Q

What is a proprietary solution available to control post conization bleeding

A

Monsell solution

42
Q

What are the most common complications of induced abortion

A

Retail price of conception, and a traders, uterine perforation, cervical laceration

43
Q

How serious is a translocated intrauterine device in the abdominal cavity

A

This is serious and may lead to life-threatening complications therefore urgent surgical removal by gynecology has to be done

EM Tintinallis (12 decks)

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