Test 1

Question 1

Invasive Breast Cancer

Answer 1

Most common, discrete, solid mass, malignant cells infiltrate

Question 2

Paget’s Disease

Answer 2

Rare, eczmetous nipple changes, discharge. Palpable mass.

Question 3

Inflammatory breast cancer

Answer 3

Rare, rapidly progressing. Skin changes. Mass or no mass.

Question 4

Carcinoma in situ

Answer 4

Pre=invasive, non-invasive, stage 0. DCIS, LCIS. Confined to ducts or lobes. Can become invasive. Rare to have palpable mass. Slow growing. Manage with lumpectomy/mastectomy and radiation.

Question 5

DCIS

Answer 5

Ductal carcinoma in situ. Earliest form of BC.

Question 6

LCIS

Answer 6

Lobular carcinoma in situ. Increased risk of BC later in life.

Question 7

Breast cancer tx options

Answer 7

Surgery, radiation, chemo, hormone therapy (adjuvant)

Question 8

Estrogen Sensitive tumor treatment

Answer 8

Estrogen promotes cancer growth. Block estrogen production with aromatase inhibitors (Anastrozole, Letrozole) or block estrogenic affects with SERMs (Tamoxifen, raloxifene). NOT BRACA 1

Question 9

Breast Conserving Surgery

Answer 9

Lumpectomy (Just tumor), Partial Mastectomy (tumor and some nodes)

Question 10

Total simple mastectomy

Answer 10

Entire breast is removed, some lymph nodes under the arms

Question 11

Modified radical mastectomy

Answer 11

Entire breast and most of the lymph nodes removed

Question 12

Breast Augmentation Screening

Answer 12

MRI better. Implants can obscure lesions. Subpectoral instead of retroglandular. Capsular Contracture common Side effect - less with Sub pectoral.

Question 13

Rotterdam Critera for PCOS

Answer 13

2 of the following Androgen excess, Ovulatory dysfunction, Polycystic ovaries

Question 14

PCOS in Adolescents

Answer 14

Androgen excess is key

Question 15

Treatments for PCOS

Answer 15

Oral contraception and metformin

Question 16

Critera for Metabolic Syndrome

Answer 16

Waist Circumference > 88cm
Elevated triglycerides >150
BP > 130/85 or active tx
Glucose levels >100 or active tx

Question 17

Physiology of PCOS

Answer 17

Lack of ovulaton, lack of progestrone, increased androgens, increase in insulin resistance (cause on obese pt), increse in LH (cause in lean pts)

Question 18

Thatcher criteria for PCOS

Answer 18

Transvaginal ultrasound shows > 12 cystic structures

Question 19

PCOS Metabolic Panel

Answer 19

Done fasting at day 2-4 of cycle. TSH and Prolactin. LH/FSH ratio. Androgens. Lipid panel, 2 hour glucose tolerance test

Question 20

LH/FSH Ratio

Answer 20

Usually 1 liklihood of PCOS increases. Hallmark symptom.

Question 21

Androgen Test PCOS

Answer 21

DHEAS is the marker of the adrenal contribution

Question 22

Common signs of PCOS

Answer 22

Cycle length >35 days, chronic pelvic pain and PMS