hello Flashcards
What is Mastodynia/mastalgia?
breast tenderness or pain
What does cyclic Mastodynia suggest?
luteal phase tenderness
Is Mastodynia increased or decreased in OCP and HRT users?
increased
What is the MOA of bromocriptine?
dopaminergic agonist that inhibits the release of prolactin from the anterior pituitary
What is the MOA of danazol?
synthetic testosterone that binds to progesterone and androgen receptor sites
What is the most common benign breast condition?
fibrocystic breast disease
What ages is fibrocystic breast disease common in?
30 to 50 yo
What is the etiology behind fibrocystic breast disease?
due to an exaggerated stromal response to hormones - assoc with a long follicular or luteal phase
What all does fibrocystic breast disease include?
cysts, papillomatosis, fibrosis, adenosis, and ductal epithelial hyperplasia
What are the most common pathologic causes of nipple d/c?
Intraductal papillomas, carcinoma and fibrocystic chgs with ectasia of the ducts (less frequently)
What are common causes of nipple d/c?
CNS lesions, hypothalamic pituitary d/o, systemic dz, medications and herbs, chest wall lesions
What is the mean age of breast cancer diagnosis?
60-61 yo
What is Rubin Maneuver?
insert index and middle fingers into vagina against the fetal posterior and anterior shoulder and push/rotate towards the fetal chest –> this helps rotate the shoulders into the oblique position
What is Woods (Screw) maneuver?
fingers are used to apply pressure posterior shoulder and push/rotate towards the fetal back –> this will rotate the fetal trunk inward about 180 degrees in a winding motion
What is Barnum (or Jacquemier) maneuver?
delivery of the posterior arm - hand is placed into the maternal sacral hollow - the fetal posterior arm is identified and pressure is placed on the antecubital fossa - this should cause forearm flexion across the chest where the forearm can be gripped extending the arm above the head and delivering the fetus arm first
What is the Zavanelli maneuver?
the infants head is replaced into the vaginal canal and uterus if possible and there is a subsequent C section –> however high infant mortality if possible
What is the treatment for Mastodynia?
acetaminophen/NSAIDs, Vit B6, Danazol, Bromocriptine Danazol is preferred over bromocriptine
What is the work up for fibrocystic breast disease?
biopsy to r/out carcinoma –> FNA is both diagnostic and therapeutic
What is the tx for fibrocystic breast disease?
may only need supportive bra, dec intake of nicotine and caffeine, there is a possible response to low salt diet and vit E supplements, HCTZ can be given premenstrually, if symptoms are severe enough Danazol can be used
What are the clinical characteristics of fibrocystic breast disease?
round, soft to firm or tense, mobile, usually TENDER, multiple and well demarcated
What is the most common causative organism of mastitis?
staph aureus
What are the clinical manifestations of mastitis?
flu like symptoms with unilateral breast tenderness that is red and warm to the touch –> diagnosis is mostly made by PE findings
What is the treatment for mastitis?
penicillinase-resistant antibiotic such as dicloxacillin or Nafcillin OR a cephalosporin
Should a lactating women continue to breastfeed after being diagnosed with mastitis?
YES, prevents the accumulation of infected material in the breast