Breast/GU Flashcards
What increases women’s risk for breast cancer?
- Increased estrogen exposure
- Age
- FH
If a patient is older than ____, what test should be done to rule out breast cancer?
> 30 –> Mammogram
If a patient is younger than ____, what test should be done to rule out breast cancer?
Ultrasound
If a patient has FH of, or a known BRCA mutation, what breast cancer imaging should be done?
MRI
What findings on mammogram point towards breast cancer? (3)
- Micro-calcifications
- Irregular borders
- Spiculations
What are some signs of possible breast cancer?
Hard, fixed mass with ill defined margins
- overlying skin/nipple changes
- axillary LAD
- nipple discharge
What are some signs of possible breast cancer?
Hard, fixed mass with ill defined margins
- overlying skin/nipple changes
- axillary LAD
- nipple discharge
What is a Phyllodes tumor?
Similar to a Fibroadenoma that more often presents in older women and has the potential to turn malignant
What will be seen on biopsy of a Phyllodes tumor?
Leaf-like projections
Describe how a Fibroadenoma will present?
Younger women with a mobile, well circumscribed mass
If a younger woman presents with a mobile and well circumscribed mass, it is likely a?
Fibroadenoma
What is unique about Fibroadenomas?
Estrogen sensitive
– may grow with pregnancy
What benign condition can present with bloody nipple discharge in a young woman?
Intraductal papilloma
What is mammary duct ectasia?
Dilation of subareolar ducts
How will mammary duct ectasia present?
Older women with green/brown nipple discharge
What benign condition presents similarly to breast cancer and even looks similar on mammogram?
Breast Fat Necrosis
What are the symptoms/mammogram signs of breast Fat Necrosis?
Painful hard mass
- Mammogram shows calcifications like breast cancer
In order to differentiate fat necrosis from breast cancer, a ____ is needed. What will that show?
Biopsy
= coarse calcifications, fat globules, foamy macrophages
Periductal Mastitis is commonly seen in patients with what 2 conditions?
Smoking
Vitamin A deficiency
In what patients is Acute Mastitis common and what is the pathogen?
Breastfeeding patients
- Staph. Aureus
How will Acute Mastitis present?
- Flu-like sx
- Red breast
- Purulent discharge
- +/- mass (abscess)
What is the treatment for Acute Mastitis?
Continued breast feeding and antibiotics
If you are suspicious of breast cancer, what is the diagnostic workup?
Mammogram
- Core/excisional biopsy
If you are suspicious of breast cancer, what is the diagnostic workup?
Mammogram
- Core/excisional biopsy
If you are NOT suspicious of breast cancer, what is the diagnostic workup?
Ultrasound
- Fine Needle Aspiration
If you are NOT suspicious of breast cancer, what is the diagnostic workup?
Ultrasound
- Fine Needle Aspiration
What pathogen often causes Acute Bacterial Prostatitis?
E. Coli
How will Acute Bacterial Prostatitis present?
- Flu-like illness
- Urinary frequency/urgency
- Dysuria and pelvic pain
What will be found on DRE with Acute Bacterial Prostatitis?
Swollen and TENDER prostate
What is Adenomyosis?
Endometrial tissue invades the myometrium of the uterus
How will Adenomyosis present?
New onset heavy and painful periods in older women
How will the uterus feel with Adenomyosis?
Symmetrically enlarged and boggy
What are uterine leiomyomas?
Fibroids = smooth muscle tumors
Uterine Leiomyomas can be asymptomatic or present how?
Heavy menses
- pelvic pressure
- constipation
- OB issues
Uterine Leiomyomas can be asymptomatic or present how?
Heavy menses
- pelvic pressure
- constipation
- OB issues
How will the uterus feel with Leiomyomas?
Irregularly enlarged uterus
What occurs to Uterine Leiomyomas following menopause?
Should shrink and become ASYMPTOMATIC
What is Endometriosis?
Ectopic implants of endometrial tissue in the pelvis/abdomen
Common symptoms of Endometriosis?
Pelvic pain with sex and at rest
Infertility
What mass can present with Endometriosis?
Endometrioma (chocolate cyst)
Endometrial cancer is a common cause of?
Post-menopausal bleeding
Hormone replacement therapy is often indicated for women with what symptoms?
Vasomotor symptoms
If a patient has recently given birth and is still breast feeding, what contraception method should NOT be used?
Estrogen containing OCPs
Why should Estrogen containing OCPs be avoided soon after pregnancy/breastfeeding?
- DVT risk
- Bad with breastfeeding
What is a contraindication for using a non-hormonal IUD, such as Copper, for contraception?
History of heavy periods because it can make them worse
What type of contraceptive method is best if still breastfeeding?
Progestin only pill or implant
– (implant is more effective)
Complete abortion
Full passage of fetal tissue + closed cervix
Incomplete abortion
Partial passage of fetal tissue + open cervix
Inevitable abortion
Vaginal bleeding + open cervix
Threatened abortion
Vaginal bleeding + closed cervix
