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Women's health trigger > breast disorders trigger > Flashcards

breast disorders trigger Flashcards

1
Q

what happens to breast epithelial cells after menstruation

A

they undergo programmed cell death at the END of luteal phase

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2
Q

when are fatty tissues almost completely replaced by breast parenchyma

A

In late pregnancy

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3
Q

psychiatric medications and nervous system medications cause what SE

A

galactorrhea

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4
Q

Anabolic steroids/Androgens are associated with what condition

A

gynecomastia

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5
Q

gynecomastia nipple retraction is suggestive of what diagnosis

A

cancer:(

any of the following = cx:
Asymmetry
Enlargement not beneath the areola
Unusual firmness
Nipple retraction
Bleeding or discharge

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6
Q

MC during 2nd/3rd week of puerperium

A

mastitis

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7
Q

CI if breastfeeding an infant thats <1month old or if there is a hx of G6PD, jaundice, or prematurity

A

bactrim for mastitis.

must use a different abx

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8
Q

where do non-puerperal peripheral breast abscesses arise from? how do you treat it?

A

skin infections (tx w I&D and same abx as mastitis)

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9
Q

this is d/t Keratin-plugged milk ducts behind the nipple.

how would you treat this.

A

non-puerperal subareolar breast abscess

  • simple I&D (40% reoccurence)
  • subareolar duct excision and complete removal of sinus tracts
  • biopsy.
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10
Q

what would suggest karyotyping for klinefelters syndrome

A

suspicious gynecomastia

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11
Q

Subareolar duct excision and removal of sinus tracts is used for what diagnosis

A

subareolar breast abscess

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12
Q

what is the etiology of fat necrosis and how do you diagnose it?

A

etiology - trauma, radiation or surgery
dx: US or mammogram. i think you can use watchful waiting though.

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13
Q

Drinking alcohol while 18-22 is the main risk for what dx

A

fibrocystic breast changes

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14
Q

s/s may be worsened w the use of caffiene in what dx?

A

fibrocystic breast changes

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15
Q

a 27 year old patient presents with cyclic breast pain that is worse just prior to menstruation. She reports multiple small bumps found in her breasts. what diagnostic will be used in this patient to assess dx?

A

US. mammograms are not indicated in pts <30!

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16
Q

what are some treatment options for fibrocystic breast changes

A
  • CAM (primrose oil/vit E)
  • NSAIDS/tylenol
  • may consider drainage of large cysts
  • severe pain - danazol, tamoxifen (limited by SE)
  • refractory severe cases = surgery.
17
Q

MC in young women within 20 years of puberty

A

fibroadenoma

18
Q

patient presents with complaints of left breast mass. on exam you see a 3cm mass that is firm, nontender, and relatively mobile. US shows well-defined solid mass with benign features. what is your diagnosis?

A

fibroadenoma

19
Q

nulliparity, early menarche, and late onset menopause are all risks for what dx

A

breast cancer

Nulliparity
First full term pregnancy after 30
Early menarche (b4 12)
Late natural menopause (after 50)
Postmenopausal combinattion HRT
Hx of uterine cx
PERSONAL HX of Breast Cx

20
Q

when do you order CBC, LFTs and ALP in this lecture

A

in initial evaluation of breast cancer

21
Q

eczematous eruption arising from the nipple with ulceration spreading to the areola. may be painful, itchy or burning

A

pagets carcinoma

22
Q

orange peel skin is assocaited with what diagnosis

A

inflammatory breast carcinoma

23
Q

blocked dermal lymphatics by a tumor emboli leading to lymphedema and hyperemia. Leads to diffuse brawny edema of skin with erysipeloid border.

what diagnosis

A

inflammatory carcinoma (orange peel skin)

24
Q

this type of cancer tends to metastasize to the liver, lungs, and brain

A

no estrogen or progesterone or HER receptors.

25
Q

this type of cancer tends to metastasize to the bone, soft tissue and genital organs

A

ER+
PR+
HER2+

26
Q

what types of breast cancer are treated w tamoxifen (TOC) or aromatase inhibitors

A

ER/PR/HER2+ cancer

tamoxifen for 5 yrs is TOC

27
Q

when is pembrolizumab used?

A

ER/PR/HER2 negative breast cancers

28
Q

this medication blocks estrogen receptors in the breast and uterus but mimics them in the bones

A

raloxifene

tamoxifen = blocks in breast, minics in bones and uterus

29
Q

this medication blocks estrogen receptors in the breast but mimics it in the uterus and bone

A

tamoxifen

raloxifene blocks breast &uterus but mimics in bone

30
Q

which SERM has less SE

A

raloxifene

31
Q

cimetidine can reduce the efficacy of this drug. this drug should also be avoided with other QT prolonging drugs

A

SERMS (raloxifene and tamoxifene)

32
Q

what are the 3 aromatase inhibitors

A

anastrazole
exemestane
letrozole

33
Q

these medications are used for metastatic breast cancer and ER or PR+, HER - cancers

A

fulvestrant
elacestrant

does not mimic estrogen, instead attatches to and causes destruction of estrogen receptors

34
Q

does not mimic estrogen, instead attatches to and causes destruction of estrogen receptors

A

fulvestrant
elacestrant

35
Q

what is the follow up regimen for breast cancer after tx

A
36
Q

what is the most specific feature of breast cx to show up on a mammogram

A

spiculated focal mass

37
Q

If a patient has a breast density of 43 what category does that put her in?

A

scattered fibroglandular densities

Predominantly fatty (0-25% dense)
Scattered fibroglandular densities (26-50% dense)
Heterogeneously dense (51-75% dense)
Dense (76% or greater dense)

38
Q

which BI-RADS score indicates screening recommendations of: Diagnostic mammo/US every 6 months x1 year, then annually for x2 years.

A

BI-RADS 3

39
Q

BI-RADS scale

A
  • 0 = not enough info, poor scan
  • 1 = negative, just routine f/u. (Q1-2 years)
  • 2 = benign, just routine f/u (Q1-2 years)
  • 3 = tiny chance of cancer, f/u (Q6 mo)
  • 4ABC = wide range, could be cancer
  • 5 = very sus!
  • 6 = yea you have cancer

Women's health trigger (23 decks)

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