quiz style questions

Question 1

a 22 y/o Type II DM female presents with fever, malaise and a tender/red Right breast for 2 weeks. The ultrasound reveals and edematous mass. What is the best treatment for this pt?

a. flagyl
b. clindamycin
c. drainage + abx
d. reassurance

Answer 1

c. drainage and abx

this is a non-lactational abscess

Question 2

intraductal papillomas are :

a. 95% malignant
b. 95%benign
c. should be excised after imaging
d. B & C

Answer 2

D.

remember this one will cause lactation and make sure its not bloody / clear

Question 3

Which one in the answers below is NOT assoc. w/ a cancerous lesion?

a. single lesion
b. hard.
c. mobile
d. irregular borders

Answer 3

c. it should be “non” - mobile which is a characteristic of cancer

cancer dont move aight!

Question 4

cancer in situ of a breast duct is considered what cancer stage?

Answer 4

stage 0

Question 5

in regards to breast cancer

a. lobular cancer make up 10%
b. ductal is well seen on mammography
c. lobular is not well seen on mammography
d. 80% are ductal in origin
e. all the above

Answer 5

e. all the above

Question 6

A pt comes in with her Left breast that looks like an orange peel almost - what are you thinking?

Answer 6

sounds like Peau d’ orange which is an inflammatory breast cancer that is < 1% in population

Question 7

What is pages dz of the breast assoc w/?

Answer 7

DCIS - ductal carcinoma in situ

Question 8

an 18 y/o female presents for cramps and intermittent pain for the last 6 hours in her lower abdomen she has a past hx of menstrual pain that has been impacting days at school lately. She is not sexually active. what should her lab work-up be?

Answer 8

chlamydia and GC

also HIV & RPR ( VDRL)

Question 9

an 18 y/o female presents for cramps and intermittent pain for the last 6 hours in her lower abdomen she has a past hx of menstrual pain that has been impacting days at school lately. She is not sexually active. she has been taking NSAIDS for the past week w/o relief of sx - what is the next step?

Answer 9

pelvic exam is warranted b/c although she may not be sexually active she may have something else going on .

This is the presentation of primary dysmenorrhea

tx = NSAIDS - mainstay
naproxen /IBU

Question 10

what are some causes of secondary dysmenorrhea?

Answer 10

endometriosis, fibroids, infection, IUD

Question 11

there are 6 tests listed under secondary dysmenorrhea - can you name 3?

Answer 11

pregnancy test
STI panel
CBC
UA
Pelvic U/S
Laproscopy 

-sounds like a ton of tests to r/o big things like ectopic pregnancy or other pelvic pathology

Question 12

a 32 y/o female presents with intermittent pelvic pain that has been getting worse with each menstrual cycle for the past year. she states he previous PCP stated she will not be able to have children but she dents remember the exact dx. On exam you note pelvic tenderness w/ uterine movement and some palpable nodules that are fixed. what is the next best step?

Answer 12

U/S
this pt has endometriosis
trx - NSAIDS + contraceptives oral

Dx is made via laparoscopy

Question 13

what is the most common tumor of the pelvis?

Answer 13

uterine leiomyomata ( fibroids)

Question 14

what percent of women will have fibroids?

Answer 14

75% …..3/4

Question 15

where are fibroids located?

Answer 15

they are in the myometrium so within the wall of the uterus and are either single or in clusters

Question 16

name some things that increase your risk for acquiring fibroids

Answer 16

early menarche
meat consumption
FH
beer
hx of uterine inf
vit d def
obesity

Question 17

what are some things that may decrease your risk for acquiring fibroids?

Answer 17

>1 pregnancy
contraceptives
smoking
green veggies + fruit
vit A
menopause
exercise

Question 18

what type of imaging is best for fibroids?

Answer 18

transvag U/S

Question 19

what is the tx for fibroids?

Answer 19

non-estrogen contraceptives
mirena , lupron

( reason being b/c fibroids are estrogen dependent )

Question 20

What labs should be ordered for a pt with fibroids?

Answer 20

CBC, TSH, Pap

Question 21

what is the difference between premenstrual syndrome and PMDD?

Answer 21

PMDD is premenstrual syndrome on steroids

you must have premenstrual syndrome + one affective sx like anger, irritability, internal tension)

Question 22

what is the tx for PMDD?

Answer 22

Yaz, w/ 4 pill-free interval
SSRI
Xanax

Question 23

how should you treat PMS in the post-menopausal?

Answer 23

oral contraceptives b/c their sx may be manifesting from lack of estrogen

Question 24

a pt w/o ever starting a mensis before her 15th birthday with normal growth and development is experiencing what dx?

Answer 24

primary amenorrhea

ovaries contain CT but no follicles

Question 25

what disorder is responsible for the most common reason women have primary amenorrhea?

Answer 25

Turners Syndrome

ovaries containt CT but no follicles