WEEK 7 END OF WEEK FORMATIVE Flashcards
Select a hormone which has a following effect - Stimulates the lactiferous duct system to grow at puberty
OPTIONS:
- A oestrogen
- B oxytocin
- C progesterone
- D prolactin
- E Growth Hormone
What is the hormone that affects the ductal growth after puberty?
A - oestrogen
Oestrogen stimulates the lactiferous ducts to grow at puberty . After menarche progesterone induces further ductal growth and development of the rudimentary lobules at the end of the ducts
During pregnancy, what causes the development of the ductal and lobular system?
What affects do they have on prolactin?
Eostrogen promotes the development of the breast ducts during pregnancy
Progesterone promotes the development of the breast lobules during pregnancy
They both cause increase prolactin secretion but also block the prolactin receptor causing no milk productio until gestation ends and their levels rapidly drop
Select a hormone which has a following effect - Stimulates the mammary glands to produce milk
OPTIONS:
- Aoestrogen
- B oxytocin
- C progesterone
- D prolactin
- E Growth Hormone
Prolactin
Select a hormone which has a following effect - Stimulates the myoepithelisal cell lining the milk ducts to contract
OPTIONS:
- A oestrogen
- B oxytocin
- C progesterone
- D prolactin
- E Growth Hormone
Oxytocin
Which hormone controls the milk let down reflex?
This would be oxytocin- this reflex is stimulated by the suckling infant which causes higher brain centres to release oxytocin which causes contraction allowing for milk production
The most common histological type of breast cancer is,
OPTIONS:
- A Ductal carcinoma in-situ
- B Fibromatosis
- C Invasive ductal cancer
- D Invasive lobular cancer
- E Mucinous carcinoma
What is the second most common type?
The most common type of breast cancer is invasive ductal cancer
The second most common type is invasive lobular cancer
Which of the following anatomical statements is not correct about the breast?
OPTIONS:
- A overlies ribs 2-6
- B Lies on pectoral fascia
- C Each mammary gland consists of 15 to 20 lobules
- D Medially, breast blood supply is from branches of the internal thoracic & anterior intercostal arteries
- E The lymphatic drainage of the lateral part of the breast drains into the internal mammary nodes
E is wrong
The lateral part of the breast drains to the axillary nodes (75% of drainage)
Most of the medial part drains into the internal thoracic lymph nodes
Which of the following is not part of triple assessment of breast conditions?
OPTIONS:
- A Clinical assessment for nipple changes
- B CT scan of breast
- C Breast Ultrasound for women under age 40 years
- D Fine needle aspiration or core biopsy
- E Mammogram for women over 40 years
B -CT scan of breast
Triple assessment is performed on woman attending a breast
clinic and includes clinical, radiological and pathological assessment. When performing radiological assessment in woman under age of 40 years ultrasound has been shown to be more effective than mammograms
Which of the following patients should the GP not refer to a breast clinic?
OPTIONS:
A 55 year old woman who has identified a new breast lump
B 23yr old woman who is breast feeding with a breast abscess
C 48 yr old woman with a blood-stained nipple discharge
D 70yr old woman with has recently noticed nipple retraction
E 42 year old woman with dimpling of the breast skin
A 23 year old woman who is breast feeding with a breast abscess - B
All the rest are potential signs of malignancy
How common is breast cancer in woman in the UK?
1in8 woman are affected by breast cancer
Which of the following is a risk factor for breast cancer?
OPTIONS:
A Lower age of first birth
B Low fat diet
C Vitamin D intake
D Early menopause
E Combined oral contraceptive pill
E - combined oral contraceptive pill
What is the percentage of breast cancers have a strong inherited familial risk?
OPTIONS:
- A 1%
- B 5%
- C 10%
- D 15%
- E 20
Name 3 gene mutations which increase the risk?
B - 5% of breast cancers have a strong inherited familial risk
- BRCA1 - 65% lifetime risk
- BRCA2 - 45% lifetime risk
- TP53 mutation
Which of these toxicities is not related to adjuvant breast radiotherapy
OPTIONS:
A Fatigue
B Hair loss
C Pulmonary fibrosis
D Localised skin reaction
E Brachial plexopathy
B - Hair loss is associated with systemic chemotherapy
Which answer is correct with regards Latissimus dorsi reconstruction ?
OPTIONS:
A Always performed as an immediate breast reconstruction
B Is a free flap
C Is always harvested by plastic surgeons
D The blood and nerve supply is provided by the thoracodorsal pedicule
E Never requires an additional breast implant to be inserted
D - the blood and nerve supply is provided by the thoracodorsal pedicule
The flap in lattisimus dorsi reconstruction for breast reconstruction is pediculed
What is the nerve supply to the lattisimus dorsi muscle?
The thoracodorsal nerve - C6,7,8
A 38 year old presents with lumpy breasts, which are painful pre-menstrually. On ultrasound scan there are several fluid filled cysts measuring from 5-15mm.
OPTIONS:
- A Lipoma
- B Intraduct papilloma
- C Fibrocyctic change
- D Phyllodes Tumour
- E Sclerosing adenosis
C - fibrocystic change
Fibrocystic change is a very common condition, characterised by a lumpy texture due to additional fibrous tissue and can cause pain and swelling that is cyclical.
