Breast/GU Flashcards by Kolbie Chancellor

What increases women’s risk for breast cancer?

Increased estrogen exposure
Age
FH

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If a patient is older than ____, what test should be done to rule out breast cancer?

> 30 –> Mammogram

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If a patient is younger than ____, what test should be done to rule out breast cancer?

Ultrasound

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If a patient has FH of, or a known BRCA mutation, what breast cancer imaging should be done?

MRI

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What findings on mammogram point towards breast cancer? (3)

Micro-calcifications
Irregular borders
Spiculations

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What are some signs of possible breast cancer?

Hard, fixed mass with ill defined margins
- overlying skin/nipple changes
- axillary LAD
- nipple discharge

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What are some signs of possible breast cancer?

Hard, fixed mass with ill defined margins
- overlying skin/nipple changes
- axillary LAD
- nipple discharge

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What is a Phyllodes tumor?

Similar to a Fibroadenoma that more often presents in older women and has the potential to turn malignant

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What will be seen on biopsy of a Phyllodes tumor?

Leaf-like projections

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Describe how a Fibroadenoma will present?

Younger women with a mobile, well circumscribed mass

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If a younger woman presents with a mobile and well circumscribed mass, it is likely a?

Fibroadenoma

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What is unique about Fibroadenomas?

Estrogen sensitive
– may grow with pregnancy

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What benign condition can present with bloody nipple discharge in a young woman?

Intraductal papilloma

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What is mammary duct ectasia?

Dilation of subareolar ducts

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How will mammary duct ectasia present?

Older women with green/brown nipple discharge

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What benign condition presents similarly to breast cancer and even looks similar on mammogram?

Breast Fat Necrosis

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What are the symptoms/mammogram signs of breast Fat Necrosis?

Painful hard mass
- Mammogram shows calcifications like breast cancer

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In order to differentiate fat necrosis from breast cancer, a ____ is needed. What will that show?

Biopsy
= coarse calcifications, fat globules, foamy macrophages

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Periductal Mastitis is commonly seen in patients with what 2 conditions?

Smoking
Vitamin A deficiency

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In what patients is Acute Mastitis common and what is the pathogen?

Breastfeeding patients
- Staph. Aureus

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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