Breast

Question 1

What are the NICE guidelines for the 2 week wait referral for breast lumps?

Answer 1

Any unexplained lump in the breast or axilla of a patient aged 30 or above

Unilateral nipple changes in patients aged 50 or above

Skin changes which are suggestive of cancer

Question 2

What are the common causes of fat necrosis?

Answer 2

Localised trauma, radiotherapy, surgery

Question 3

What is a galactocele?

Answer 3

Milk filled cysts which occur when the lactiferous duct is blocked, preventing the gland from draining milk

Question 4

What is the fancy name for breast pain?

Answer 4

Mastalgia

Question 5

How can cyclical breast pain be diagnosed?

Answer 5

Breast pain diary

Question 6

What is galactorrhoea?

Answer 6

Breast milk production which is not associated with pregnancy or breast feeding

Question 7

Which class of drugs can cause galactorrhoea?

Answer 7

Dopamine antagonists (i.e. antipsychotic medication) because dopamine supresses the release of prolactin

Question 8

Which drugs can be used to suppress prolactin secretion?

Answer 8

bromocriptine or cabergoline (dopamine agonists)

Question 9

What are the common causes of hyperprolactineamia?

Answer 9

Idiopathic
Prolactinomas
Endocrine disorders such as hypothyroidism and PCOS
Medications

Question 10

Which visual defect can prolactinomas cause?

Answer 10

Bitemporal heminopia

Question 11

What are the common causes for gynaeomastia?

Answer 11

Obesity
Testicular cancer (leydig tumor)
Liver cirrhosis/ failure
Hyperthyroidism
HCG secreting tumour (SC lung cancer)
kleinfelter sydrome
drugs

Question 12

Why can spirolactone cause gynaecomastia?

Answer 12

Inhibits testosterone production and blocks testosterone receptors

Question 13

What are the management options for gynaecomastia?

Answer 13

Treat underlying conditions

Tamoxifen

Surgery

Question 14

What is the presentation of duct ectasia?

Answer 14

intermittent discharge from the nipple which may be white, green or grey

Tenderness or pain

Question 15

What can be found on a mammogram in duct ecstasia?

Answer 15

microcalcifications

Question 16

What is the major risk factor in developing duct ectasia?

Answer 16

Smoking

Question 17

What is the presentation of intraductal papilloma?

Answer 17

Clear or blood stained discharge

Question 18

What is the presentation of mastitis?

Answer 18

unilateral Breast pain
Erythema
Local warmth and inflammation
Nipple discharge
Fever

Question 19

What is the first line antibiotic for mastitis?

Answer 19

Flucloxacillin

Question 20

What is the management for candida of the nipple?

Answer 20

Topical miconazole to each nipple

oral miconazole or nystatin for the bébé

Question 21

What is the management of non-lactational mastitis?

Answer 21

Analgesia
Antibiotics
treatment for the underlying cause

Question 22

What are the two genres of abscess?

Answer 22

Lactational and non-lactational

Question 23

What is the most common bacterial cause of breast abscesses?

Answer 23

Staph aureus

Question 24

What are the features of a breast abscess on palpation?

Answer 24

Swollen, fluctuant, tender lump

Question 25

Which antibiotics are recommended for non-lactational mastitis?

Answer 25

Co-amoxiclav

Erythromycin plus metronidazole

Question 26

Which chromosome is the BRCA 1 gene found on?

Answer 26

17

Question 27

Which chromosome is the BRCA 2 gene found on?

Answer 27

13

Question 28

Who is eligable for the NHS breast screening programme?

Answer 28

Women aged 50-70 are eligible for a mammogram every 3 years

Question 29

What are the 2 week wait criteria for a referral to breast clinic?

Answer 29

An unexplained lump in the breast or axilla in a patient aged >30

Unilateral skin changes in patients aged 50 or above

Skin changes suggestive of cancer

Question 30

Where are the most common sites for breast cancer to metastasise to?

Answer 30

Lungs
Liver
Bones
Brain