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Clin Med Repro > Breast DO > Flashcards

Breast DO Flashcards

1
Q

What is the #1 breast problem seen in primary care?

A

Breast pain

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2
Q

The vast majority of mastalgia is ??

A

Hormonally regulated

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3
Q

Does breast pain = cancer?

A

Rarely

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4
Q

What is cyclic breast pain often associated with?

A

Hormonal changes - usually 1 week prior to onset of menses

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5
Q

What can cause cyclic breast pain?

A

Proliferation of normal glandular breast tissue

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6
Q

If a patient presents with cyclic breast pain, what should you do?

A

US, add mammogram if over 30!

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7
Q

Sharp or burning breast pain is characterized as?

A

Non-cyclic breast pain

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8
Q

Non-cyclic breast pain is often _____

A

unilateral

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9
Q

How do you manage non-cyclic breast pain?

A

US, add mammogram if over 30

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10
Q

How do you treat breast pain?

A

Usually self-limited
Supportive garments
Analgesics
Evening primrose oil

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11
Q

What is the only FDA approved Rx for treatment of mastalgia? Why do people usually not use it?

A

Danazol

Significan androgenic effects!

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12
Q

Nipple discharge is usually?

A

Benign

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13
Q

Bilateral milky nipple discharge involving multiple ducts

A

Galactorrhea - physiologic nipple discharge

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14
Q

What causes galactorrhea?

A

Hyperprolactinemia

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15
Q

What is suspicious nipple discharge?

A

Secretory production of fluids other than milk

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16
Q

What is the most common cause of pathologic nipple discharge?

A

Papilloma - papillary tumor growing from lining of breast duct

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17
Q

What should clue you in to pathologic breast pain?

A 
Spontaneous
Unilateral
Confined to one duct
Bloody
Clear, yellow, white, dark green
Associated with a mass
Women age over 40
18
Q

What tests should you order to evaluate nipple discharge?

A

hCG
Prolactin
TSH
Renal function

19
Q

What is a crucial step in diagnosing a benign breast lump/mass?

A

EXCLUDING BREAST CA

20
Q

What do you need to make sure to document when evaluating a breast mass?

A

Clock or vertical system

21
Q

Solid, firm, mobile mass “rolled to an edge” that is typically found in young women 15-35

A

Fibroadenoma

22
Q

Fluid-filled mass, compressible or ballotable that is typically found in premenopausal or perimenopausal women

A

Cyst

23
Q

Diffuse, tender, does not form discrete or well-defined mass that is associated with cyclic breast pain and premenopausal women

A

FIbrocystic changes

24
Q

What should you suspect if you find nodular breast tissue on PE?

A

Fibrocystic changes

25
Q

Due to milk retention cyst in breast feeding women

A

Galactocele

26
Q

Can develop after trauma, surgery, radiation, or after breast augmentation/reduction procedures

A

Fat necrosis

27
Q

What is the “triple test” to diagnose a breast mass?

A
  1. Physical exam
  2. Mammography
  3. Needle biopsy
28
Q

What is the most common solid benign breast mass?

A

Fibroadenoma

29
Q

Definitive diagnosis of a fibroadenoma?

A

CNB or excision

30
Q

Influenced by hormonal fluctuation, can change in size with menstrual cycle

A

Breast cyst

31
Q

Breast cysts are uncommon in postmenopausal women unless they are using??

A

Hormone therapy

32
Q

How do you confirm a breast cyst?

A

US (simple cyst) or fine needle aspiration

33
Q

When do you refer someone with a breast cyst to surgery?

A

If the aspirate is bloody, does not result in complete collapse with aspiration, or recurs multiple times in a short period

34
Q

Localized, painful inflammation of breast associated with fever and malaise

A

Lactational mastitis

35
Q

What happens if you don’t treat mastitis?

A

Local abscess formation

36
Q

What bacteria usually causes mastitis?

A

S. aureus

37
Q

What is the treatment for mastitis?

A

Dicloxacillin or clindamycin for MRSA coverage

38
Q

Benign proliferation of glandular tissue in male breast that is unilateral or bilateral

A

Gynecomastia

39
Q

What causes physiologic gynecomastia?

A

Hormonal imbalance

40
Q

What causes pathologic gynecomastia?

A

Drugs, cirrhosis, hypogonadism, tumors, CKD

41
Q

Definitive diagnosis of breast mass is made by ???

A

Breast biopsy

42
Q

What is better, a breast biopsy or imaging?

A

Biopsy always!

Clin Med Repro (7 decks)

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