MDTs With Hallmarks Flashcards
What are fibrocystic changes?
Painful breast masses.
Pain worsens pre menstrual
Rapid fluctuation normal
Most frequent lesion
Ages 30-50
Avoid trauma
Vitamin E
NSAIDs
What is fibroadenoma?
Common benign neoplasm most frequently in young women.
Within 20 yrs after puberty
Black women
Accidentally discovered
1-5 cm, rubbery, discrete
Gen surgery referred
3-4 cm
Rule out phyllodes
What is fat necrosis?
Rare lesion of the breast.
Indistinguishable from carcinoma.
Seen after fat injections.
Trauma is cause
Ecchymosis
Untreated may disappear
Biopsy, core needle
What is female breast carcinoma?
Second most common cancer in women, second leading cause of cancer death. 1 in 8.
60s to 70s then declines
BRCA 1 and BRCA 2
Nulliparous or late first pregnancy
Early menarche and late menopause
Mammography 2 years
Under 40 no
40-49 if yes every two years
50-74 every two years
Over 75 if gonna live ten more years
Painless lumps, single non-tender with Ill defined margins
Phosphates alkaline and serum calcium
Core needle biopsy
Treat with surgical resection, radiation, and systemic therapy
Reoccur most frequently in first 2-5 years every 6 months
20-25% contralateral
What is male breast carcinoma?
Rare with 1% of all breast cancer.
Age over 70
First degree relatives/men with breast cancer are at risk.BRCA 2 mutations.
Gyneocomastia
Treatment same in female breast carcinoma.
Node negative 88
Node positive 69
What is nipple discharge?
Characteristics of nipple discharge need to be evaluated by history and physical examination.
Serous- benign FCC duct ectasia
Bloody-neoplastic papilloma/carcinoma
Mass-neoplastic
Unilateral-neo or non neo
Bilateral-non neo
Relation to menses
Pre vs post menopause
Taking any hormones
Occurrence
Treatment of underlying cause
Most discharge is benign
Every 3-4 months re examined
What is abnormal uterine bleeding?
Mean blood loss is 40mL
Menorrhagia-blood loss over 80 mL
Metrorrhagia-bleeding between periods
Polymenorrhea-bleeding that occurs more often than every 21 days
Oligomenorrhea- less frequently than every 35 days
Heavy, light, menstrual, intermenstrual
PALMCOEIN
Adolescents, anovulation
19-39 pregnancy, lesions, anovulatory,hormonal contraceptives, endometrial hyperplasia
Painful cramping, spotting, anemia
Refer OBGYN
Post menopausal consider cancer
What is PMDD?
Premenstrual dysphoric disorder.
PMDD are heavier PMs symptoms that impact functionality and social relationships.
40% 25-40 yrs
5-8 % will be severe
Treat Underlying cause
Daily diary for 2-3 months
Continuous symptoms may indicate depression vs PMDD
Treatment is lifestyle changes
Ssris if symptoms mood disorders
“Tine” and “pram”
What is vaginitis?
Inflammation and infection of the vagina.
Pathogens,allergic reactions,atrophy,friction.
Recent sexual history, onset of the LMP, use of contraceptives,tampons,or douches.
Irritation or itching
Malodorous
Inflammation, cervical tenderness, adnexa tenderness
Ph greater than 4.5 in vaginalis or BV
Vulvovaginal Candidiasis-fluconazole 150mg daily for 1 day
Trichimonas vaginalis vaginitis- metronidazole 2g po x 1 500mg BIDx 7 days
Bacterial Vaginosis
Metronidazole 500mg BID x 7 days
Clindamycin vaginal cream
Metronidazole gel
Chlamydia
Doxycycline 100mg BIDx 7 days
Gonorrhea
Ceftriaxone 500mg IMx 1 dose
Avoid sex, douching, nonabsorbent underwear
What is bartholins gland abscess?
Trauma or infection to the bartholin duct which may cause obstruction of the gland.
Periodic painful swelling introitus
Dyspareunia
Fluctuate swelling 1-4cm
Under 40 don’t require treatment unless large or problem with intercourse
Over 40 biopsy or removal are recommended
