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OB/GYN > Breast Disorders > Flashcards

Breast Disorders Flashcards

1
Q

List some differential diagnoses of a breast mass

A

Fibrocystic changes of the breast
Fibroadenoma
Carcinoma
Intra-ductal papilloma
Little benign growths that cause bloody nipple discharge
Fat necrosis
Duct ectasia
abscess
cyst

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2
Q

What is the most common organism in mastitis?

A

S. aureus

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3
Q

Mastitis in a non-lactating female need to rule out what?

A

inflammatory carcinoma

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4
Q

Most common reason for fever after the immediate puerperium in nursing mothers

A

Mastitis

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5
Q

More common within three months of delivery and in first time mothers

A

Mastitis

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6
Q

What is the treatment for mastitis?

A

Ibuprofen
Cold compress
Frequent nursing
Dicloxaxillin or Cephalexin if indicated

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7
Q

What are some risk factors for breast abscess development?

A

obese
smoking
black
blocked milk duct
nipple piercings

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8
Q

Female appearing male breast

Enlargement of the male breast, often asymmetric or unilateral

A

Gynecomastia

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9
Q

Gynecomastia must be distinguished from what?

A

tumors or mastitis

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10
Q

Which type of gynecomastia is characterized by tenderness, while the other type of gynecomastia is typically non-tender?

A

Glandular gynecomastia

Fatty gynecomastia

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11
Q

What genetic disorder is it common to see gynecomastia?

A

Klinefelter Syndrome

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12
Q

Lactation that occurs in the absence of nursing

A

Galactorrhea

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13
Q

Evaluation of galactorrhea should be done if present in nulliparous female, or if associated with what symptoms?

A

headache
amenorrhea
visual changes
systemic symptoms

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14
Q

What are some causes for galactorrhea?

A

Medications
CNS lesions (i.e. pituitary microadenomas (measure prolactin))
Medical conditions

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15
Q

What is the test of choice for galactorrhea?

A

MRI

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16
Q

Indications for an MRI in galactorrhea?

A

Prolactin >200mg/dL in the non-pregnant

Patients with headaches, vision changes

Persistent increase in prolactin

17
Q

In fibrocystic breast disease, size and tenderness fluctuates with what two factors?

A

menstruation cycle and caffeine

18
Q

Most common etiology of breast “lump” – benign solid mass

Common benign neoplasm in young women

Fibrous and glandular tissue

A

Fibroadenoma

19
Q

Firm, round, non-tender, mobile

“rubbery”

Usually solitary and unilateral

Palpable and visible on ultrasound

A

Fibroadenoma

20
Q

On physical exam of a fibroadenoma, what are the 5 Rs?

A

R – round
R – rubbery
R – recluse (unilateral)
R – roaming (mobile)
R – really doesn’t hurt (non-tender)

21
Q

Second most common malignancy in women

A

breast cancer

22
Q

Second most common cause of cancer death in women

A

breast cancer

23
Q

What is the most common type of breast cancer?

A

infiltrating ductal carcinoma (80%)

24
Q

What is the most lethal type of breast cancer?

A

inflammatory

25
Q

What is the largest risk factor for breast cancer?

A

age

26
Q

List some risk factors for breast cancer

A

Age
BRCA1 and 2 mutations
Family history in a first-degree relative
Early age of menstrual onset (<12 years old)
Delaying childbearing or nulliparity (First pregnancy after 30)
Radiation exposure
Overweight after menopause
2-4 alcoholic drinks per week
Hormone therapy
Not breast feeding
White
History of atypical hyperplasia
Tobacco use

27
Q

What are common sites of metastases for breast cancer?

A

Lymph notes (most common)
Lung/pleura
Liver
Bone
Brain

28
Q

What is the most common site for breast cancer metastases?

A

Lymph notes (most common)

29
Q

How do you get a definitive diagnosis of solid breast tumor?

A

Excisional breast biopsy

30
Q

What type of breast cancer is described below?

Pre-maligment lesion

Arises from ductal hyperplasia

Asymptomatic

Usually not palpable

Contained within the mammillary ducts

A

Ductal Carcinoma In-Situ

31
Q

What type of breast lesion is described below?

Contained within breast lobules

Usually bilateral

Not palpable and doesn’t show up on a mammogram

Diagnosis is usually incidental on biopsy

A

Lobular Carcinoma In-Situ

32
Q

What type of breast cancer is described below?

Most common breast malignancy

Worse and most invasive

Typically post-menopausal women

Firm, fibrous, rock-hard mass with sharp margins

Likes to metastasize

A

Infiltrating Ductal Carcinoma

33
Q

What type of breast cancer is described below?

Second most common breast malignancy

Usually bilateral

Arises from lobular epithelium

A

Infiltrating Lobular Carcinoma

34
Q

What is the most common breast malignancy?

A

Infiltrating Ductal Carcinoma

35
Q

What type of breast cancer is described below?

Infiltrating intra-ductal carcinoma in the nipple and ducts of nipple

Often associated with DCIS

Eczematous changes of the nipple

Crusting, scaly lesion

A

Paget’s Disease of the Nipple

36
Q

What type of breast cancer is described below?

Extremely aggressive malignancy

Poorly differentiated tumor with dermal lymphatic invasion

Edema, erythema, peau d’orange, warm skin overlying the breast

May present like mastitis in a non-lactating woman

Most malignant form of breast cancer

Tends to occur in younger women

Characterized by rapid enlargement of breast without underlying mass

A

Inflammatory Breast Carcinoma

37
Q

Most malignant form of breast cancer

A

Inflammatory Breast Carcinoma

OB/GYN (14 decks)

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