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OBS and gynae > breast IOD > Flashcards

breast IOD Flashcards

1
Q

which tumour under microscopy has cell in a single file and a dysfunction in the E-cadherin-catenin system

A

lobular carcinoma

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2
Q

which tumour describes: a well circumscribed with well differentiated glands embedded into well differentiated connective tissue stroma

A

breast fibroadenoma

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3
Q

breast cancer that express ER

A

ER positive is less aggressive and more likely to respond to hormone therapy

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4
Q

breast cancer that over express HER

A

poorer prognosis but more likely to respond to herceptin

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5
Q

what is associated with microcalcifcations

A

DCIS can be seen in mammogram

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6
Q

how does DCIS and ductal carcinoma present

A

ductal carcinoma presents as a mass, DCIS: confined within basement membrane

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7
Q

What are the six different prognostic factors for breast cancer

A

tumor stage, tumour grade, histological subtype, vascular invasion, excision margins, oestrogen and HER2

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8
Q

what is the most prognostic factor in breast cancer

A

tumour stage and in particular the lymph nodes

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9
Q

What are the three compensation mechanisms for acid

A

buffering, compensation and treatment

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10
Q

What are the three mechanisms for buffering

A

bicarbonate in the serum and phosphate in the urine, skeleton and intracellular loss of H+

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11
Q

Characteristics of compensation of acid

A

diametric opposite, never overcompensates and delayed and limited

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12
Q

how do we treat to compensate acid

A

precipitating solution

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13
Q

iron requirment for men and women aged 11-18

A

men: 11 and women: 15

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14
Q

iron requirement for men and women aged 19-50

A

men: 8 and women: 18

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15
Q

iron requirement for men and women aged 7-12 months

A

11 for both

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16
Q

What is the most common cancer in the UK

A

breast cancer

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17
Q

lifetime risk of breast cancer in the UK

A

1-8 women

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18
Q

in which ages in breast cancer most likely

A

40-70 yr

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19
Q

Before what age is breast cancer less likely to develop

A

25 years

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20
Q

three major risk factors for breast cancers

A

family history, prolonged oestrogen exposure and alcohol consumption

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21
Q

Which genes can lead to increased risk of breast cancer

A

BRACA 1 and BRACA 2

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22
Q

under which inheritance pattern is BRCA gene inherited

A

autosomal dominant

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23
Q

by what percentage does each additional alcoholic drink increase the risk of developing breast cancer

A

10%

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24
Q

apart from breast cancer, what other cancer is at a higher risk of having BRACA

A

ovarian cancer and do a bilateral masectomy

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25
Q

What are the four characteristics of a malignant cell

A

pleomorphism, hyperchromasia, increased nuclear:cytoplasmic ratio and mitotic actvity

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26
Q

in which ages would you consider a mammogram

A

age over 35

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27
Q

in which ages would you consider an ultrasound

A

age under 35

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28
Q

why would you do a mammogram in older patients

A

you can see microcalcifications more clearly

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29
Q

why would you do a ultrasound in younger patients

A

you can see more dense tissue and identify solid and cystic lesions

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30
Q

What does C1/B1 refer to

A

inadequate sample

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31
Q

what does C2/B2 refer to

A

benign

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32
Q

what does C3/B3 refer to

A

equivocal favour benign

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33
Q

what does C4/B4 refer to

A

equivocal favour malignant

34
Q

what does C5/B5 refer to

A

malignant

35
Q

Which C/B stage does DCIS refer to

A

C5/B5

36
Q

what does a increased urea/creatinine ration refer to

A

there is a problem with the kidneys

37
Q

Define fibrocystic change

A

minor aberrations to cyclical hormonal chnage

38
Q

painful lump in breast during second half of cycle

A

fibrocystic change

39
Q

In which age is fibrocystic age common

A

25-45

40
Q

treatment of fibrocystic change

A

reassurance, analgesia, aspiration or excision

41
Q

Which three factors reduce the release of ADH

A

decreased plasma osmolality, increase in plasma volume and ethanol

42
Q

What is the ages for the NHS breast screening program

A

47-73 years every 3 years before 50-70

43
Q

Where do all breast cancers arise from

A

from epithelial cells lining the terminal duct lobular unit

44
Q

what type are 75% of breast cancers

A

ductal carcinoma

45
Q

What part of the lung does mesothelioma affect

A

lining of the pleura

46
Q

latency period of mesothelioma

A

40 years

47
Q

what do fibroblasts secrete in the interstitium during DLPD

A

collagen

48
Q

three organisms that causes severe CAP

A

strep pneumoniae, legionella, Stpah auerus

49
Q

which organism is the main cause of infective excacerbation of COPD and then pneumonia

A

1)h. influenzae and 2)s.pneumoniae

50
Q

What are the other three types of breast cancer apart from lobular and ductal

A

tubular, cribriform and mucinous

51
Q

most common organisms that cause HAP

A

gram negative, klebsiella, e-coli and pseudomonas aeruginosa

52
Q

What are the three risk factors for lung cancer in non-smokers

A

industrial hazards, epidermal growth factor and environmental hazards like radon gas

53
Q

What is main demographic in patients with sjorgens syndrome

A

50 year old women

54
Q

sensitivity and specificity of ANA testing

A

high sensitivity but low specificity

55
Q

A negative ANA will rule out which diseases

A

SLE, sjorgens syndrome, systemic sclerosis

56
Q

Which drugs can increase the risk of a positive ANA

A

hydralazine, isonazid and procainamide

57
Q

Which infections can you see a positive ANA

A

TB, mononucleosis, hepatits c, subacute bacterial endocarditis

58
Q

When should the three serum tryptase samples be taken

A

15min-3 hr, 3-6hr 24-48hr

59
Q

when should serum tryptase levels return to normal after an allergic reaction

A

12-14

60
Q

What does a persistently raised serum tryptase suggest

A

mastocytosis

61
Q

rules for antihistamines when doing a skin prick test

A

stop 5-7 days before

62
Q

2 preformed and 2 synthesised inflammatory mediators

A

preformed: histamine and tryptase, synthesised: prostaglandin and leukotrienes

63
Q

in which region is beta thalassemia present in higher levels

A

pakistan

64
Q

IgA endomysial antibodies, IgA tTG antibodies

A

coeliac disease

65
Q

Anti-gastric parietal cell antibodies

A

atrophic gastritis, pernicious anaemia

66
Q

anti-intrinsic factor antibodies

A

pernicious anaemia

67
Q

anti-mitochondrial antibodies,anti-PDH antibodies

A

primary biliary cirrhosis

68
Q

anti-smooth muscle antibodies

A

autoimmune hepatitis

69
Q

anti-glomerular basement membrane antibodies

A

good-pastures syndrome

70
Q

anti-PR3, cANCA

A

Granulomatosis with polyangitis, Eosinophilic granulomatosis with polyangiitis

71
Q

pANCA

A

granulomatosis with polyangitis, eosinophilic granulomatosis with polyangitis and UC

72
Q

anti-cardiolipin antibodies

A

antiphospholipid syndrome

73
Q

anti-skin antibodies

A

phemphigus and phemphigold

74
Q

anti-adrenocortical antibodies

A

addisons disease

75
Q

anti-SSA (Ro) and anti-SSB (La)

A

sjorgens

76
Q

anti- cyclic citrullinated peptide antibodies

A

rheumatoid arthritis

77
Q

anti-acetylcholine receptor antibodies

A

myasthenia gravis

78
Q

define chronic spontaneous urticaria

A

spontaneous hives or angioedema or both daily or almost daily for atleast 6 weeks

79
Q

6 steps of management for chronic spontaneous urticaria

A

1) stop exacerbating factors
2) anti-histamines
3) short courses of steroids for 10 days for acute exacerbations
4) h2 receptor blocker- rantidine
5) leukotriene receptor- montelukast
6) IgE antiboidy: ozliumab

80
Q

increased risk of breast cancer thriugh family history

A

Breast cancer in a first-degree male relative of any age
Breast cancer in a first-degree relative under the age of 40
Bilateral breast cancer in a first-degree relative under the age of 50
Breast cancer in two first-degree relatives

OBS and gynae (17 decks)

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