Breast/ Endo

Question 1

Red, nonspecific eczematoid rash affecting nipple and areola, Paget cells within the dermis

Answer 1

Paget disease of the nipple

Question 2

Treatment for Pagets disease of the nipple with no additional carcinoma focus

Answer 2

Breast-conserving wide local excision of the nipple and underlying area

Question 3

Treatment for Pagets disease of the nipple with identified carcinoma focus or widespread ductal carcinoma

Answer 3

total mastectomy

Question 4

Follow up guidelines s/p mastectomy for breast CA

Answer 4

6 monthly clinical review, yearly mammography of remaining breast

Question 5

bilateral nipple discharge, thick, greenish-yellow colour, foamy macrophages, normal ductal cells and debris on cytology

Answer 5

Mammary duct ectasia (fibrocystic breast change)

Question 6

Treatment for recurrent thyrotoxicosis s/p subtotal thyroidectomy

Answer 6

Carbimazole + radioactive iodine ablation

Question 7

DM drug contraindicated in chronic renal failure

Answer 7

Metformin

Question 8

DM drug with risk of exacerbating heart failure

Answer 8

Rosiglitazone

Question 9

Features of Addisonian crisis

Answer 9

vomiting precipitating circulatory decompensation, hypotension, hyponatremia, hypochloremia, hyper pigmentation

Question 10

Defect in 21 hydroxylase causing aldosterone synthesis deficit, predisposing to life threatening salt loss at an early age, usually neonatal

Answer 10

Salt-losing congenital adrenal hyperplasia

Question 11

Focal breast lesions in young patients; symptomless, some benign macroscopic calcification

Answer 11

Fibroadenoma