Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB/GYN > Breast Med > Flashcards

Breast Med Flashcards

1
Q

When milk production is not necessary, ______ is inhibited by ______ (from the ______)

A

Prolactin
Dopamine
Hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Other hormones that influence the milk secretory system include…

A 
Progesterone
Insulin
Cortisol
Thyroxine
Oxytocin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Breast Masses

A

Simple Cyst
Fibrocystic condition
Fibroadenomas
Cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nipple discharge; causes:

A

Carcinoma
Intraductal papilloma
Galactorrhea
“Cig”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Breast Infections

A

Mastitis

Abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mastodynia/Mastalgia

A

Cyclic and non-cyclic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Generally, abnormal breast masses are eval by sono in women _____ and by _____ in women ______

A

30 years and younger,

mammo in women 30 plus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cysts are benign developments in _______ women

A

middle aged women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cyst PE

A

palpable, unilateral soft to firm, round, mobile mass that is often tender.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cyst dx requires

A

radiograph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cyst tx

A

aspirate, but monitoring without aspiration is sometimes acceptable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what do you do with bloody or turbid aspirated fluid from a cyst?

A

cytology, some are excised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When do you excise a cyst?

A

bloody fluid, palpable mass after aspiration, fluid reaccumulates in two weeks, or cyst recurs even after 2 aspirations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

a condition where cysts of microscopic or larger size develop in the breasts and surrounding tissue becomes thickened, bumpy, and fibrous.

A

Fibrocystic Breast Disease/Hyperplasia without atypia…..Glandular and ductal tissue may also change.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fibrocystic condition rarely develops in ______ ____

A

postmenopausal women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In Fibrocystic Breasts, breasts can change ______ and masses can _______

A

size

disappear and reappear cyclically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

______ discharge may be normal with changes premenstrually in Fibrocystic Breasts

A

Serous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the plan of action with a patient with possible Fibrocystic Breasts?

A

either confirm radiographically, or have pt return next time they are in the premenstrual area and evaluate then.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Plan if dx remains uncertain after US/Mammo, or if pt’s age or family hx causes concern—

A

Aspirate for bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fibroadenomas are?

A

benign tumors of unknown etiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Age typical of Fibroadenomas?

A

Usually women < 30, including adolescents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Physical Exam may reveal unilateral, round, smooth, mobile, firm/rubbery mass usually 1 cm or larger and non-tender

A

Fibroadenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Physical Exam may reveal bilateral, clumpy, mobile, symmetrical masses, and possibly multiple masses

A

Fibrocystic Breast Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Physical exam reveals a palpable, unilateral, soft to firm, round, mobile mass that is often tender

A

Cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Fibroadenomas do not require further tx beyond routine clinical eval if…

A

confirmed radiographically + pt is <30yoa + no family hx of breast ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Fine needle aspiration(FNA) should be done on Fibroadenomas if…

A

Sono or mammo leave doubt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

3 tx routes of Fibroadenomas

A

(if confirmed by bx!)
left alone
tx with cryoablation
excised if large

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

bx of solid breast masses on imaging are _____ if less than 30yoa, and _____ if older than 30yoa

A

fine-needle-aspiration

core-needle biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In any solid mass bx where results are nondiagnostic then _______

A

an excisional bx is required!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

The most common presenting sx of pt’s with breast ca is…

A

a mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Breast ca masses may first be detected through

A

self-exam
clinical exam
screening mammo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Other initial detections of breast ca could include ____ ______, _____ in breast shape, or ____ changes

A

nipple discharge
change in breast shape
skin changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Progression of breast ca may present with sx/signs like …..

A

weight loss, anorexia, night sweats, and fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Breast ca may metastasize to

A

bone, liver, lung, pleura, brain, or lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Physical Exam may reveal a firm to hard, usually non-tender mass that is difficult to distinguish from surrounding tissue, non-mobile, usually unilateral

A

Breast CA masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Most common Breast CA

A

Infiltrating ductal carcinoma (IDC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Least common types of Breast CA

A

Invasive lobular carcinoma(ILC)
Ductal carcinoma in situ(DCIS)
Lobular carcinoma in situ (LCIS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Paget Disease of the Nipple is where….

A

the epidermis of the nipple is affected.

is a form of ductal carcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Examination of pagets reveals

A

crusting, scaling, erosion around the nipple. discharge is common.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Inflammatory breast carcinoma is very aggressive and is described as….(dismal prognosis)

A

the skin will be erythmatous, warm and have peau d’orange. Axillary lymph nodes are palpable, but no detectable mass.
Nipples may become inverted.

41
Q

Dx of inflammatory breast carcinoma by

A

punch bx when suspicion is a reasonable step.

42
Q

A new-onset breast mass in a women >50 years old…

A

is considered cancer until proven otherwise

43
Q

What if a palpable mass is not detected on mammo?

A

get sono

44
Q

BRCA 1 &2 are what and cause what

A

tumor suppressor genes.

a mutation here leads to uncontrolled cell growth

45
Q

“increased risks” categories for breast ca prevention tx such as tamoxifen or raloxifene or aromatase inhibitors are..

A

age, family hx, personal hx, or assessment tool value of 3% or higher

46
Q

___% of women with breast cancer do not have an obvious risk factor other than age

A

75%!!!

47
Q

__-__% of breast cancers are a result of BRCA 1 and 2 mutations

A

5-10%

48
Q

Uses of Tamoxifen (Soltamox)

A
  • SERM- Breast ca prevention/treatment.

- post and pre menopausal women.

49
Q

Raloxifene

A
  • SERM- Breast ca prevention.(only in Postmenopausal women)

- Osteoporosis tx (but no longer highly recommended)

50
Q

Contraindications of Tamoxifen and Raloxifene

A

hx of clots.

pregnancy.

51
Q

Aromatase inhibitors are…

A

used for breast ca prevention in postmenopausal women only

52
Q

Clinical Breast Exams may occur every…

A

1-3 years in pt’s that are 25-39 years, and annually from 40 years.

53
Q

USPSTF recommends mammos every__ in pt’s ____-____years

A

2 years

50-74 years old

54
Q

ACOG recommends mammos annually at age ___

A

40

55
Q

When do you start screening a pt with a first degree relative with pre-menopausal breast cancer?

A

10 years earlier than the cancer was first detected in the relative

56
Q

When do you start screening a pt who has tested positive for a BRCA mutation?

A

Start screening mammos or MRI at age 25

57
Q

USPSTF states perform a risk assessment for an inheritable syndrome using a tool IF a pt has….

A

a family hx of breast, ovarian, tubal or peritoneal ca, OR if Ashkenazi Jewish ancestry.
Risks from Gina:
Family hx of b,o,t,p, ca before age 50, bilat breast ca, both breast and ovarian ca(or two types of BRCA-related ca), breast ca in a male, multiple cases of breast ca in the fam, Ashkenazi Jewish ethnicity

58
Q

_____ all pt’s with abnormal sonogram or mammo for bx

A

refer

59
Q

Bx will include 1. 2. 3.

A
  1. histological analysis
  2. whether or not the cells are estrogen/progesterone-receptor-positive
  3. if there is ERBB2(HER2/neu) over-expression
    If analysis is neg for both estrogen and progesterone receptors and for ERBB2, it is called “triple-negative” breast cancer
60
Q

ERBB2 is an

A

acquired mutation found in 25% of breast ca’s; it stimulates cell growth and can be a more aggressive ca than other cancers without this mutation.

61
Q

TNM (and stages)

A

Tumor
Node
Metastasis
stages include: 0, I, IIA, IIB, IIIA, IIIB, IIIC, IV

62
Q

Most reliable predictor for survival is…

A

the stage of breast cancer at the time of dx

63
Q

____ ____ ____ and ___ ____ _____ are major prognostic factors of breast cancer.

A

Lymph node status

Hormone receptor status

64
Q

If cancer has spread to the lymph nodes it is…

A

2x more likely to metastasize

65
Q

If cancer is hormone receptor positive, it has a…

A

lower recurrence rate and is therefore a favorable prognosis

66
Q

Tx of breast cancer will be guided by…

and could include….

A

histological analysis and staging, and could include lumpectomy, mastectomy, axillary lymph node dissection, radiation (in most pt’s), hormonal therapy (SERMS and/or AIs), tissue-targeted therapy and chemotherapy.

67
Q

Induction (preoperative) chemotherapies may be used to…

A

shrink tumor to allow for breast conserving surgery in nonmetastatic cases.

68
Q

Chemo, Hormonal and TTTs may be started before…

A

Surgery

69
Q

Breast conservation surgery can only be given to pt’s who can

A

receive adjuvant radiation.

70
Q

Avoid prescribing these if a pt comes to you on Tamoxifen.

Why?

A 
Paroxetine
Fluoxetine
Bupropion
Duloxetine
will lower effectiveness
71
Q

Hormonal therapy in hormone receptor positive cancer includes _____ and/or ___ for how long?

A

SERMS (Tamoxifen for tx and prevention of recurrence, Raloxifene for prevention of recurrence)
AIs
for 5 years following cancer tx (some pts will take a SERM for 5 years followed by an AI for 5 years)

72
Q

AI MOA

A

Aromatase Inhibitors are antineoplastic agents for post-menopausal women with receptor-positive cancer. they BLOCK CONVERSION of ANDROGENS to ESTROGEN

73
Q

Risk of AIs

A

accelerate bone loss

74
Q

Chemo is used if ____ _____ test positive or….

A

lymph nodes

tumor is larger than 1cm, or if bx shows ERBB2 overexpression

75
Q

The need for chemotherapy in a pt with stage I or II HRP cancer can be determined by….

A

Oncotype DX test which looks at the genetic likelihood of recurrence or spread

76
Q

ERBB2(HER2) ________ is an indication for ______ plus a _______/__________

A

Overexpression
Chemo
Tissue-targeted medication/ERBB2 directed monoclonal antibodies

77
Q

Second line tx’s for menopausal/vasomotor symptoms

A

gabapentin or clonidine

78
Q

Completed care by oncologist(1year)…pt should receive….

A

thorough H&P with clinical breast exam every 3-6months for 3 years, then every 6-12 months for 2 years, then annually….

79
Q

Annual _____ mammos should be done on patients who…

A

Diagnostic…who are breast ca survivors

80
Q

Serous or yellow-tinged discharge from nipples without any red flags can be normal phys changes associated with…

A

menses, OCPs, or Fibrocystic changes.

81
Q

Red flags of discharge

A 
Bloody
Unilateral and Persistent
Mass is near by
or
Spontaneous
(bUmPs)
82
Q

SOAP documentation should include:

A

Color, bilateral or unilateral, spontaneous or expressed, presence or absence of associated mass or lymphadenopathy, any associated skin changes, history of trauma

83
Q

Most common cause of bloody nipple discharge is?

A

Intraductal Papilloma

a benign, unilateral lesion

84
Q

Plan with pt’s suspected of intraductal papillomas

A

1 send discharge to cytology to rule out invasive carcinoma
2 mammo and subareolar US may help to exclude cancer
Tx: excise the duct

85
Q

Drugs that can cause Gynecomastia

A 
Ginko
Yheroin
N
Etoh
C
Omeprazole, Opiods
Methyldopa, Marijuana
Azole
Spironolactone, Saw palmetto, supplements
TCAs, Testosterone, Tamoxifen 
dIaepam
fInesteride
Amphetamines
86
Q

Galactorrhea is -

A

spontaneous flow of milk from the nipple - caused by high levels of prolactin in the blood from pregnancy, a pituitary tumor, hypothyroidism, excessive exercise, renal failure, or a side-effect of certain medications

87
Q

Meds that lower _____ levels will trigger a rise in prolactin levels such as:

A

Dopamine.

Antipsychotics, cimetidine(Tagamet), metoclopramide, SSRIs, TCAs, Verapamil, and opiates.

88
Q

Three steps of ddx for Galactorrhea

A

1 consider pregnancy and meds.
2 then order prolactin and thyroid levels, if thyroid is normal but prolactin is high then
3 order a MRI of sella turcica to eval for pituitary tumor/adenoma

89
Q

Mastitis is caused usually by:

A

Staph aureus

90
Q

Mastitis Tx:

A

Dicloxacillin 500mg qid for 10 days.

Hospitalize pt if severe.

91
Q

Breast Abscess cause and tx.

When would you bx?

A

usually a collection of pus in a blocked milk duct/galactocele.
Dicloxacillin 500mg qid (Bactrim if MRSA suspected)
Drain the abscess with needle or incision.
Bx if it does not resolve promptly and the pt is not lactating.

92
Q

Breast tenderness (mastodynia/mastalgia) is usually ____

A

cyclic

93
Q

Things that increase pain of cyclic mastalgia

A

OCP, HRT

94
Q

Causes of non-cyclic breast pain

A

OCPs, HRT, SSRIs, Spironolactone and digoxin.

95
Q

Treatment of Mastalgia

A

NSAIDs(including topical diclofenac), Vit B6, Tamoxifen, and/or a well-fitted bra

96
Q

Mastalgia may be a comp from…

A

breast augmentation - scarring around the implant can result in breast firmness, distorted shape and pain

97
Q

Imaging of mastalgia is only done when…

A

pain is focal, and no cause for pain can be identified

Or pt has risk factors

98
Q

Documentation of a mass includes:

A

Location, size, shape, unilateral/bilateral, soft/firm, smooth/rough, tender/non-tender, mobile/non-mobile

99
Q

Documentation of discharge includes:

A

Color, consistency, presence or absence of blood, unilateral / bilateral, spontaneous

OB/GYN (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions