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SRGRY3 > BRST > Flashcards

BRST Flashcards

1
Q

The breast is composed of how many lobes?

A

15-20

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2
Q

What do you call the fibrous bands of connective tissue traveling through the breast?

A

Cooper Suspensory Ligaments

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3
Q

The mature female breast extends from the level of
the _______ rib to the inframammary fold at the ______ rib. It extends transversely from the lateral border of the sternum to the _______

A

2nd-3rd rib
sixth or seventh rib
anterior axillary line

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4
Q

What do you call the accessory areolar glands?

A

Montgomery’s glands

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5
Q

Breast changes during pregnancy

A

Breast enlarges
Ductal and Lobular Epithelium proliferates
Areolar skin darkens
Accessory areolar glands become prominent

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6
Q

Breast changes during the first and second trimesters

A

minor ducts branch and develop

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7
Q

Breast changes during the third trimester

A

fat droplets accumulate

alveolar epithelium and colostrum fills the alveolar and ductal spaces

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8
Q

Breast changes in late pregnancy

A

Prolactin stimulates the synthesis of milk fats and proteins

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9
Q

Which o the following changes in the breast is NO associated with pregnancy?
A. Accumulation of lymphocytes, plasma cells, and eosinophils within the breast.
B. Enlargement of breast alveoli.
C. Release of colostrum.
D. Accumulation of secretory products in minor duct
lumina.

A

C

Colostrum is released after parturition

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10
Q

This initiates contraction of the myoepithelial cells which results in compression of alveoli and expulsion of milk into the lactiferous sinuses

A

Oxytocin

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11
Q

The breast receives its blood supply from all of the following EXCEPT
A. Branches of the internal mammary artery
B. Branches of the superior epigastric artery
C. Branches of the posterior intercostal arteries
D. Branches of the thoracoacromial artery

A

B

The breast receives its principal blood supply from:

(1) perorating branches o the internal mammary artery;
(2) lateral branches o the posterior intercostal arteries; and (3) branches from the axillary artery, including the highest thoracic, lateral thoracic, and pectoral branches o the thoracoacromial artery.

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12
Q

Which o the following statements is INCORRECT ?
A. Level I lymph nodes are those that are lateral to the
pectoralis minor muscle.
B. Level II lymph nodes are located deep to the pectoralis
minor muscle.
C. Level III lymph nodes are located medial to the pectoralis
minor muscle.
D. Level IV lymph nodes are the ipsilateral internal mammary
lymph nodes.

A

D

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13
Q

Hormone responsible for ductal development

A

Estrogen

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14
Q

Hormone responsible for lobular development

A

Progesterone

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15
Q

Hormone responsible for lactogenesis

A

Prolactin

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16
Q

Concerning gynecomastia, which o the following is true?
A. During senescence, gynecomastia is usually unilateral.
B. During puberty, gynecomastia is usually bilateral.
C. Is not associated with breast cancer except in Ehlers-
Danlos patients.
D. Is classifed as per a three-grade system.

A

D;

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17
Q

Three phases in which gynecomastia usually occur

A

neonatal period
adolescence
senescence

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18
Q

What is common to phases of life wherein the development of gynecomastia is common?

A

Excess of circulating estrogens

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19
Q

In this phase of life gynecomastia is caused by fall in circulating testosterone levels

a. neonate
b. adolescence
c. senescence

A

C

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20
Q

Gynecomastia commonly occur in what age during adolescence?

A

12-15 years

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21
Q

What findings in gynecomastia suggest possibility of breast cancer, particularly in the older male

A

Dominant masses or areas of firmness

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22
Q

Gynecomastia generally does not predispose the male breast to cancer except in _______

A

Klinefelter (XXY)

23
Q

mild breast enlargement without skin redundancy, what Grade of Gynecomastia is this?

A

Grade I

24
Q

marked breast enlargement with skin redundancy and ptosis, what gynecomastia is this?

A

Grade 3

25
Q

Type of gynecomastia related to the resumption of pituitary gonadotropin secretion after pituitary shutdown.

A

Refeeding Gynecomastia

26
Q

The following drugs that induce gynecomastia through the inhibition or synthesis of testosterone EXCEPT

a. cimetidine
b. ketoconazole
c. phenytoin
d. furosemide
e. diazepam

A

D

27
Q

Drugs that inhibit the action or synthesis of testosterone that induce gynecomastia

a. reserpine
b. theophylline
c. spironolactone
d. antidepressants

A

C

28
Q

a chronic inflammatory condition that originates

within the accessory areolar glands of Montgomery or within the axillary sebaceous glands

A

Hydradenitis suppurativa

29
Q

a variant of thrombophlebitis that involves the superficial veins of the anterior chest wall and breast.

A

Mondor disease

30
Q

a recurrent periductal mastitis, which is a condition of recurrent retroareolar infections and abscesses.

A

Zuska disease

31
Q

Inflammatory conditions o the breast include all o the
following EXCEPT
A. Necrotizing viral mastitis
B. Zuska disease (recurrent periductal mastitis)
C. Mondor disease (superfcial breast thrombophlebitis)
D. Hidradenitis suppurativa

A

B

32
Q 
Lesions with malignant potential include all of the following EXCEPT
A. Intraductal papilloma
B. Atypical ductal hyperplasia
C. Sclerosing adenosis
D. Atypical lobular hyperplasia
A

C

33
Q

The occurence of a second breast cancer outside the breast quadrant of the primary cancer (or at least 4 cm away) is called

A

multicentricity

34
Q

The occurence of a second cancer within the same brest quadrant as the primary cancer (or within 4cm of it) is called

A

Multifocality

35
Q

Cytoplasmic mucoid globules are a distinctive cellular feature of this/these condition/s

a. LCIS
b. DCIS
c. both
d. neither

A

A

36
Q

True of LCIS

a. it is more common than DCIS
b. more common in African american women than white women
c. average age at diagnosis is 45 years
d. NOTA

A

C

a. DCIS is more common
b. more common in white

37
Q

Which of the following favor DCIS

a. Incidence of synchronous invasive carcinoma is 5%
b. no signs and symptoms
c. no mammographic findings
d. less common in premenopausal

A

D.

38
Q

50 year old patient with mass, pain, nipple discharge. On mammogram, microcalcifications corresponding to mass was found.

a. LCIS
b. DCIS
c. could be either

A

B;

LCIS - no symptoms, no mammographic signs

39
Q

True of LCIS

a. 40-80% multicentricity (therefore less than DCIS 60-90%)
b. 10-20% bilateral (therefore less than DCIS 50-70%)
c. Ductal Histologic type
d. NOTA

A

C

40
Q

The risk in invasive breast cancer is increased by how much in women with DCIS

a. three-fold
b. four-fold
c. five-fold
d. six-fold

A

C

41
Q

To qualify as a special-type cancer, at least what percentage of the cancer must contain the defining histologic features?

A

90%

42
Q

Which of the following describes comedo histologic type?

a. high nuclear grade, extensive necrosis, high DCIS grade
b. Intermediate nuclear grade, focal or absent necrosis, intermediate DCIS grade
c. Low nuclear grade, absent Necrosis, low DCIS grade

A

A

b. intermediate
c. noncomedo

43
Q

Chronic eczematous eruption of the nipple which may be subtle but may progress to an ulcrated, weeping lesion.

A

Paget’s disease of the nipple

44
Q

Paget disease is usually associated with extensive

a. LCIS
b. DCIS
c. both
d. neither

A

B

45
Q

Describe the pathognomic finding if Paget’s disease of the nipple

A

large, pale, vacuolated cells (Paget Cells) in the rete pegs of the epithelium.

46
Q

Paget’s disease may be confused with superficial spreading melanoma. The following differentiates the two

a. S-100 antigen immunostaining in Paget’s
b. CEA in melanoma
c. both
d. neither

A

D

S-100 in melanoma
CEA in Paget’s

47
Q

What is the surgical therapy for Paget’s?

A

Lumpectomy or mastectomy depending on the extent of involvement of the nipple areolar complex

48
Q

What is the most common pathologic subtype of breast cancer?

A

Invasive ductal carcinoma of the breast with productive fibrosis (Scirrhous, simplex, NST)

49
Q

Invasive ductal carcinoma scirrhous type, asymptomatic, what is the chance of axillary lymph node metastases?

A

25%;

60% if symptomatic

50
Q

2% of all invasive breast cancer, typically presents in elderly population as a bulky tumor. Defined by extracellular pools of mucin, surrounded by aggregates of low-grade cancer cells.

a. medullary
b. papillary
c. adenoid cystic
d. colloid

A

D. colloid/mucinous

51
Q

2% of all invasive breast cancers, generally presents at 7th decade of life, typicall small (<3cm), low frequency of axillary lymph node mets

a. medullary
b. papillary
c. adenoid cystic
d. Tubular

A

B

52
Q

Long-term survival is 100%, will develop axillary lymph node mets but distant mets rare, 94% to express estrogen receptor.

a. medullary
b. papillary
c. adenoid cystic
d. adenocarcinoma scirrhus

A

D

53
Q

10% of breast cancers, histopath: small cells with rounded nuclei, inconspicuous nucleoli, and scant cytoplasm. Special stains show signet ring cell.

a. Paget’s disease of the nipple
b. Invasive lobular carcinoma
c. Invasive ductal carcinoma
d. adenocarcinoma scirrhus

A

B

54
Q

What percent of lobular carcinoma express estrogen receptor?

A

90%

SRGRY3 (44 decks)

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