Brainscape's Knowledge GenomeTM

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


See full index

Clin Med Final Material- Semester 2 > Disorders of the Breast and Lactation- Paulson > Flashcards

Disorders of the Breast and Lactation- Paulson Flashcards

1
Q

Anatomy of the breast:

A

nodes

?

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

Supernumerary Nipple/Breast:

  • found ?
  • Dangerous: Y/N?
A
  • Found along milk line
  • Not dangerous
  • May darken during pregnancy
    Hormonal changes in pregnancy may cause increase in size/possible lactation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Gynecomastia=

A

Enlargement/swelling of breast tissue

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

T/F: gynecomastia can be unilateral or bilateral

A

True

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

gynecomastia is an indicator of ______ imbalance

A

hormone (increased estrogen)

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

Gynecomastia:

-demographic?

A

Occurs in males often during puberty or in elderly (decreased testosterone)

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

Gynecomastia often occurs 2/2 ____

A

meds–> ie Spironolactone, risperidone

-*also seen in cirrhosis or other dz processes

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

Mastodynia(Mastalgia)=

A

Breast tenderness

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

Mastodynia(Mastalgia):

  • How common?
  • often ____
A
  • Common
  • Often cyclical (hormonal changes)
  • **Cyclic pain is usually during luteal phase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mastodynia(Mastalgia):

-increased in women taking ____

A

OCP’s or HRT

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

Mastodynia(Mastalgia):

-tx?

A

Treat with reassurance, vitamin B6

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

Mastitis= _____ infection

A

breast

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

Mastitis:

  • +/- breast _____
  • MC organism?
A
  • May have breast abscess

- ***Most often caused by Staph aureus (KNOW)

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

Mastitis:

-MC demographic?

A
  • Occur primarily in lactating women
  • Poor latch or incomplete emptying of breast
  • Unilateral tenderness, heat, significant fever/chills, body aches (flu-like symptoms)
  • Usually one quadrant of breast/lobule affected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mastitis:

  • Cultures needed?
  • tx? KNOW
A
  • Culture of purulent material/milk usually not done
  • Treat with antibiotics usually with ***(dicloxacillin)=1st line. or cephalosporin and warm compress (example: Dicloxacillin 500mg po q 6 hours x 10 days) or a cephalosporin for 10-14 days.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mastitis:

  • can mothers continue breastfeeding?
  • tx for abscess?
A
  • *Continue breastfeeding

- Surgical treatment may be necessary for abscess

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

Breast Abscess=

A

Painful, swollen area of redness, tenderness, and induration (filled with pus)

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

Breast abscesses usually develop during ______

A

lactation

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

Breast Abscess:

-tx?

A
  • Need I&D and antibiotics

- **Usually dicloxacillin

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

Breast abscess:

-Subareolar abscess may develop in _______

A

non-lactating women

-(hint: nipple piercing)

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

Breast Abscess:

-If patient DOES NOT respond to treatment, suspect:

A

inflammatory breast cancer especially if associated with axillary lymphadenopathy**

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

Fat Necrosis of Breast is a malignant or benign condition?

A

-benign

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

Fat Necrosis of Breast:

  • etiology?
  • Hx of?
A
  • Damaged/dead breast tissue
  • Hx of trauma or surgery
  • Firm nodule
  • Can occur after breast biopsy, surgery, or radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Fat Necrosis of Breast:

-May look like _______ on imaging

A

breast carcinoma

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

Fat Necrosis of Breast:

  • dx?
  • Risk factors?
A

Need biopsy to determine
Excision not needed
No increased risk of breast cancer

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

Fibrocystic Breast changes are the most frequent _____

A

benign condition of the breast

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

Fibrocystic Breast changes:

  • MC age?
  • associated Sx
A

Most common age is 30-50 years

  • Usually bilateral, mobile
  • Can have cyclic pain or breast tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Fibrocystic Breast changes:

______ ______ usually distinguish from carcinoma but any suspicious lesion should be biopsied or excised

A

Multiple lesions

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

Fibrocystic Breast changes are related to Related to _____ changes

A

hormonal changes**

(estrogen and progesterone stimulate increase in size) that produce the lumps

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

Fibrocystic Breast changes:

-describe the pain assoc. with menstrual cycles

A

Bilateral pain and size fluctuation during menstrual cycle (common to have symptoms during premenstrual period)

-Treat with supportive bra

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

Fibrocystic Breast changes:

-Possible role of _______

A

caffeine avoidance, low salt diet, Vitamin E, evening primrose oil

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

Fibrocystic Breast changes:

-Sx subside at ________

A

menopause

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

Fibroadenoma:

  • what is it?
  • how common?
  • Pt demographic
A

=Benign tumor of glandular breast tissue
-Second most common benign breast disorder

  • Occur in young women
  • More common in Black women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Fibroadenoma:

-Typical appearance:

A

Typically round or ovoid, firm, smooth, rubbery, discrete, mobile, non-tender

35
Q

Fibroadenoma:

-dx?

A

Core needle biopsy or 3-6 month follow up with repeat ultrasound and breast exam

36
Q

Fibroadenoma:

-tx?

A
  • No tx necessary if dx made by core needle bx
  • May surgically remove if patient wants
  • Cryoablation is an alternative
37
Q

Nipple Discharge:

-can be normal _______

A

lactation

38
Q

Nipple Discharge:

  • Galactorrhea=
  • -what does it result from?
A
  • Milky white discharge, usually bilateral

- Frequently result of hyperprolactinemia (meds or tumor)

39
Q
  • Pathologic Nipple Discharge :
  • -causes?
  • -discharge is usually _______
A
  • Causes are duct ectasia, intraductal papilloma, and carcinoma
  • Discharge is usually unilateral, from single duct
40
Q
  • Pathologic Nipple Discharge:

can be serous, bloody or _________

A

serosanguineous

41
Q

Pathologic Nipple Discharge

is purulent with breast _______

A

abscesses

42
Q

Pathologic Nipple Discharge:

-dx?

A
  • Order imaging (ultrasound/mammogram)
  • Refer

-Cytological exam of nipple discharge rarely helpful b/c negative does not R/O cancer

43
Q

Pathologic Nipple Discharge:

tx?

A

Surgical excision of involved duct usually for treatment and diagnosis

44
Q

intraductal papilloma:

A

small, benign tumor that forms in the duct, made of glandular and fibrous tissue as well as blood vessels

45
Q

duct ectasia=

A

duct widens and its walls thicken. Can lead to duct blockage and fluid buildup.

46
Q

Breast Cancer:

-General stats and risk factors

A
  • Increases with age
  • 1 in 8 American women will develop breast cancer
  • Mean age dx is 61 years
  • **Genetic predisposition BRCA1 and BRCA2

-Risk factors include: nulliparity, early menarche, late menopause, long-term estrogen or radiation exposure, delayed childbearing >30yo, first degree relatives (especially if more than 1), hx of endometrial cancer

47
Q

Breast Cancer Types: (list 2 types)

A
  • Non invasive

- invasive

48
Q

Breast Cancer:

-Describe Non-invasive (2 Ex’s)

A
  • Ductal carcinoma in-situ

- Lobular carcinoma in-situ

49
Q

Breast Cancer:

-describe invasive (list 2 ex’s)

A
  • Invasive ductal carcinoma (80-85% of breast cancers)

- Invasive lobular carcinoma

50
Q

OVERALL, increased ______ exposure, increases one’s risk of developing breast CA

A

estrogen

51
Q

Ductal Carcinoma:

-describe the process of a normal duct—> invasive ductal carcinoma

A

Normal duct–> Ductal hyperplasia–> Atypical hyperplasia–> DCIS (in situ)–> invasive

52
Q

Paget Disease of Breast:

-how common?

A

RARE– 1% of all breast CA

53
Q

Paget Disease of Breast:

-if there is an underlying palpable mass:

A

usually invasive infiltrating ductal carcinoma

54
Q

Paget Disease of Breast:

-if NO palpable mass:

A

usually DCIS or noninvasive breast cancer

55
Q

“looks like eczema of their nipple”

A

THINK paget disease

56
Q

Paget Disease of Breast:

-only about ___% NOT associated w cancer

A

15%

57
Q

Paget Dz of the breast:

-describe the presentation

A

Presents as eczematous or ulcerated lesion of the nipple

May be pruritic, burning, or painful

58
Q

Paget Dz of the breast:

  • refer?
  • tx?
A

Refer for full thickness biopsy

-Usually treated with mastectomy

59
Q

Lobular Carcinoma:

-LCIS is usually an ______

A

incidental finding

-**Lobular = Lucky find!

60
Q

Lobular Carcinoma:

  • increased risk of _____
  • discuss?
A

Increased risk of developing breast cancer

-Discuss options – excise lesion, offer chemoprevention, refer

61
Q

Invasive Carcinoma:

-S/Sx

A

Fixed firm nodule
Usually non-tender but can also have breast pain
Dimpling of skin
Retraction of nipple
Nipple discharge
Breast size changes
Skin thickening: peau d’ orange (orange peel skin)
Eczematous changes
Axillary node enlargement
Arm edema
Palpable Supraclavicular/infraclavicular nodes

62
Q

Remember MC area for breast cancer to occur is ___________

A

upper outer quadrant

63
Q

Self and Clinical Breast Exam:

Describe Breast Self awareness

A
  • Women should be familiar with breasts

- Report any changes to your doctor

64
Q

Self and Clinical Breast Exam:

-describe clinical breast exam

A

Research hasn’t shown a clear benefit to clinical breast exam or self breast exam if a woman is getting mammograms (ACS, 2020)

65
Q

Mammography:

-annually starting at age ___

A

**40yo and continuing for as long as a woman is in good health. Can switch to every other year at age 55. (ACS)

  • Biennial screening mammogram between the ages of 50yo – 74yo (USPSTF, 2016)
  • Women ages 60-69 are most likely to avoid breast cancer death due to screening mammography
66
Q

The decision to start screening mammography before age 50 is ________

A

individual

-If a woman/her provider decide to proceed, biennial screening between the ages of 40-49 recommended (USPSTF, 2016)

67
Q

Cons of mammographies

A

Larger numbers of false positives and unnecessary biopsies

68
Q

For women at high-risk, recommend ____ in addition to mammogram every year starting at age 30 (ACS)

A

MRI**

69
Q

For a Pt with Known BRCA mutation or untested but have first degree relative with a BRCA mutation, what imaging study should they undergo?

A

-MRI

-also MRI for Pts:
w/ Greater than 15-20% lifetime risk based primarily on family hx
Risk calculator:
https://bcrisktool.cancer.gov/calculator.html

-OR Prior radiation to chest

70
Q

Breast CA: dx

A
  • Early carcinoma may appear with mammographic changes and no palpable mass
  • Combination of physical exam, mammography (best screening tool), ultrasonography, fine needle, or core needle biopsy, and/or excisional biopsy (core biopsy is preferred**)!!
  • Biopsy specimen undergo tumor marker testing - estrogen and progesterone receptor analysis as well as Her2/neu testing, and histologic analysis
71
Q

Breast CA: dx

-additional testing?

A

May require additional testing such as MRI, CT, chest x-ray, bone scan, PET scan

72
Q

Breast CA: tx

A
  • Staging should occur before treatment begins
  • Lumpectomy with sentinel node biopsy is often preferred with early stage cancer
  • Mastectomy
  • Radiation therapy
  • Adjuvant chemotherapy or hormonal therapy benefit some
  • Palliative
73
Q

Breast CA:

-Major prognostic factors

A

Tumor size
Tumor grade
Lymph node involvement/metastasis
Age

74
Q

Breast CA:

-F/U care?

A
  • Monitored long term to detect recurrence, most commonly occur within first 2-5 years
  • First 2 years, examine every 6 months with mammogram, then annually after
75
Q

Breast Cancer in Men

A

-**Rare, breast cancer in men only 1% of that in women

=A painless lump beneath areola in a man usually >50yo

  • Nipple discharge, retraction, or ulceration may be present
  • Generally a poorer prognosis than in women
  • Possible increased incidence in men with prostate cancer
76
Q

_____ mutations are common in men with breast cancer

A

BRCA2

77
Q

Lactation:

-breast milk has the right amount of:

A

fat, sugar, water, protein, and minerals needed for a baby’s growth and development. As a baby grows, breast milk changes to adapt to the baby’s changing nutritional needs.

78
Q

T/F: breast milk is easier to digest than formula

A

true

79
Q

Breast milk contains antibodies that:

A

protect infants from certain illnesses, such as ear infections, diarrhea, respiratory illnesses, and allergies.
**The longer baby breastfeeds, the greater the health benefits.

80
Q

Breastfed infants have a lower risk of ________

A

sudden infant death syndrome (SIDS).

81
Q

American Academy of Pediatrics recommends exclusive breastfeeding for the first __ months of a baby’s life, followed by breastfeeding in combination with the introduction of complementary foods until at least 12 months of age, and continuation of breastfeeding for as long as mutually desired by mother and baby

A

6 months

82
Q

Breast changes in pregnancy

A

Breast development during pregnancy -> hormone dependent growth -> growth and branching of the ductal system and fat deposition

-Estrogen
-Prolactin
-Growth Hormone
-Adrenal Glucocorticoid
Insulin

83
Q

Breastfeeding: Let Down Reflex

-Prolactin:

A
  • Released by anterior pituitary
  • Stimulated by signals from nipple to hypothalamus
  • Promotes mammary glands to start producing milk/milk secretion
  • Stimulates colostrum
84
Q

Breastfeeding: Let Down Reflex

-oxytocin:

A
  • Released by posterior pituitary, stimulated by signals from suckling or crying
  • Stimulates smooth muscle contraction, helps eject milk
  • Milk letdown from the mammary gland of the breast into the ductal system

Clin Med Final Material- Semester 2 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions