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Trimester 7 > OBGYN > Flashcards

OBGYN Flashcards

1
Q

what is NOT a reason a regular pelvic exam is performed?

A

to screen for pregnancy

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2
Q

which CIN classification would indicate mild dysplasia and precancerous cells?
what does CIN stand for?

A

CIN I
cervical intraepithelial neoplasia

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3
Q

_____, ____ and ____ are used in the TNM staging system for breast cancer.

A

Tumor- Node- Metastasis

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4
Q

which two conditions commonly occur while breastfeedinb?

A
  • galactocele- mastitis
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5
Q

fibrocystic breast disease is classified by

A

multiple cysts in breast- painful- size and pain fluctuates

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6
Q

lithotomy position for pelvic exams is?

A

on back with knees bent

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7
Q

label 1-12

A
  1. Mons Pubis
  2. prepuce of clitoris
  3. urethral opening
  4. vestibule
  5. hymen torn
  6. perineum
  7. anus
  8. posterior fourchet
  9. labia majora
    10 vaginal entrance
  10. labia minora
  11. glans of clitoris
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8
Q

what is the AKA for Mons Pubis?

A

Mons Veneris

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9
Q

name the fatty tissue covering the symphysis pubis, covered by hair post puberty, located where the anterior aspects of the labia majora unite forming an elevation over the symphysis pubis

A

mons pubis

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10
Q

this is the outermost region of the external genitalia subcutaneous folds seen as 2 folds

A

labia majora

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11
Q
  • large hair covered folds of skin- external part- contain sebaceous glands and subcutaneous fat- internal part-
A

labia mojora

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12
Q

what does this describe ? skin of vulvar area- slightly more pigmented- in nulliparous patient the lips nearly touch, in parious patient- lips are separated

A

labia majora

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13
Q

what does this decribe? anterior fusion of this structure forms the anterior commissure, posterior fusion of this structure forms the posterior commissure

A

labia majora

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14
Q

this structure lies medially to labia majora, no hair covering, seen as two folds of skin extending from midline just over the clitioris and ending on either side of the vaginal introitus

A

labia minora

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15
Q

this structure is dark pink in color, rich supply of venous sinuses, sebaceous glands and nerves, at anterior aspect each one ? splits into 2 folds- posterior folds form the clitoral frenulum and anterior folds unite to form a hood like configuration over the clitoris forming the prepuce.

A

labia minora

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16
Q
A

clitoris

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17
Q

enlargement of the clitoris may relate to ____ abnormalities rather than inflammatory conditions

A

endocrine

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18
Q

this area is between the inner surfaces of the labia minora located from the clitoral frenulum to the fourchette. it surround the vaginal introitus, skin more delicate that labia majora, mc site of granulomatous and ulcerative lesions in younger women and of malignant changes in elderly, fourchet is the posterior part of the this structure- anterior to the perineum

A

vestibule

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19
Q

this is an area of tendon attachments, wedge shaped mass of fibrous tissue situated between the lower end of the vaginal introitus and the anus, externally (portion of structure) seen as a midline seam of skin that terminates at the anus, this overlies the (structure) body- it is point of attachment of many perineal muscles including the levator ani muscles, these muscles assist (structure) in supporting the posterior wall of the vagina-

A

perineal body

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20
Q

episiotomy performed in this area

A

perineal body

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21
Q

this area is also called introitus

A

urethral orifice

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22
Q

this structure is visible between the clitoris and vaginal orifice, opening, 1” posterior to clitoris, normal is slit like or stellate and is same color as surrounding mucous membranes

A

urethral orifice- introitus

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23
Q

these glands are a series of small para-urethral glands along either side of the urethra, mucus forming glands that are equal to prostate in males, often involved in gonorrheal or chlamydial infections, mild these by anterior motion after finger inserted in vaginal orifice

A

skenes glands

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24
Q

this structure is posterior to the urethral orifice, the hymen appears just inside (this structure) thin mucus membrane- perforated with one or more holes, in virgin the size and thickness vary- elastic and breaks at first intercourse- remnant will always remain,

A

vaginal orifice- introitus

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25
Q

what is imperforate hymen

A

when vaginal orifice is completely covered with hymen

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26
Q

what is this?

A

annular hymen

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27
Q

what is this?

A

cribriform hymen

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28
Q

what is this?

A

septate hymen

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29
Q

what is this?

A

parous introitous

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30
Q

these glands are located within vaginal orifice at inner edge of labia, at 4 and 8pm positions, function is lubrication, not normally palpable, often involved with gonorrhea infections, ducts can become clogged forming cysts or abscesses

A

bartholin glands

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31
Q

what structures are considered internal genitalia?

A

vagina
fornix
uterus
uterine tubes

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32
Q

this structure is from vulva to uterus, made from stratified squamous cells, erectile tissue for expansion and contraction, located posterior to bladder and urethra, anterior to rectum, vagina runs anterior to posterior and inferior to superior direction, approx, 10 cm long.

A

vagina

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33
Q

what are the functions of the vagina?

A

receive penis during intercourse
excretory duct for menstrual flow
excretory for childbirth

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34
Q

this structure is the superior domed part of the vagina, a recess around the cervix, attaches to the sides of the cervix so that a part of the cervix extends into the vagina

A

fornix

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35
Q

what are the 4 regions of the fornix

A

they are called fornices- anterior, posterior- and right and left lateral

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36
Q

describe this area circled

A

cul-de-sac of douglas- the region posterior to the posterior fornix- a pouch in peritoneal cavity- between the vagina and cecum

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37
Q

what is a culdocentesis?

A

aspiration of fluid in the cul-de-sac of douglas- clear is good, blood or pus is a problem

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38
Q

list the vaginal support structures

A
  • cardinal ligament- around fornix
  • levator ani muscles
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39
Q

this structure is the organ of gestation, medium sized inverted pear, located posterior to bladder, anterior to rectum, superior to vagina- weigh approx 1/5 oz, 3” long, 2” wide and 1” thick

A

uterus

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40
Q

this structure can expand up to 500 x its size for fetus growth,

A

uterus

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41
Q

what are the ligaments that support the uterus?

A

round ligament and broad ligament

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42
Q

this is the superior aspect of the uterus- lies above the entrance of the uterine tubes

A

fundus

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43
Q

this is the main part of the uterus, lies between the dundus and cervix, geings just below entrance of uterine tubes- narrows inferiorly where it becomes continuous with the cervix

A

body of uterus

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44
Q

this part of the uterus is located above vaginal opening- waist of the uterus, constriction between the body of uterus and cervix, this area marks the junction of the cervix and the body

A

isthmus

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45
Q

this part of the uterus- inferior aspect of the uterus, peirces the anterior wall of vagina, divided into supravaginal and vaginal parts of the cervix, cervical cavity/canal is spindle shaped- OS

A

cervix

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46
Q

this part of the cervix- superior aspect half of the cervical canal - opening slightly smaller than external (portion)

A

internal os

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47
Q

this part of the cervix- inferior aspect- half of the cervical canal- visible during pelvic exam-

A

external OS

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48
Q

where does the external OS open into?

A

superior aspect of vagina

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49
Q

circular shape of external ox means?

A

nulliparous woman (no births)

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50
Q

where would you find external is transverse slit with an anterior lip and posterior lip/slit?

A

parous woman vaginal part of cervix is larger in parous women

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51
Q

what are the 3 layers of the uterine wall?

A

perimetrium- myometrium- enometrium

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52
Q

uterine wall- this is serous outer layer

A

perimetrium

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53
Q

uterine wall- internal to perimetrium, thic muscular wall made up of smooth muscles, supported by connective tissue

A

myometrium

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54
Q

uterine wall- this is the mucous membrane which is 3 layers

A

endometrium

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55
Q

uterine wall- part of the endometrium- this layer is permanent- thin layer, contiguous with the myometrium

A

basal layer

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56
Q

uterine wall- part of the endometrium- this layer is the “shed” layer- it is the middle layer of endometrium between stratum basale and stratum compactum-

A

spongiosa layer

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57
Q

uterine wall- endometrium- this layer contains dilated and toruous poertions of the uterine glands

A

spongiosa layer- shed

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58
Q

uterine wall- endometrium- this layers is also a “shed” layer- it is relatevely dense superficial layer (innermost layer) of the endometrium

A

compacta layer

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59
Q

uterine positions- deflection of the long axis of the uterus in reference to the long axis of the body

A

version

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60
Q

uterine positions: this is the most common presentation- axis of uterus is deflected anteriorly

A

anteversion

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61
Q

uterine position: with anterverted _____ and _____ is normal presentation for _____ body of the uterus tipped slightly anteriorly- what position is this?

A

position is anterversion

  • anterversion and anteflexed
  • pregnancy
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62
Q

with anteversion which direction does the cervix point?

A

points downward- posterior/inferior

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63
Q

this uterine position- axis roughly parallel

A

midposition

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64
Q

uterine position- axis deflected posterior

A

retroversion

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65
Q

uterine positions- with retroverted/retroflexed- abnormal- felt with rectal palpation- cervix points upward- anterior and inferior- body of uterus tipped slightly posterior- often seen in women with endometriosis

A

tretroversion

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66
Q

iif the uterus is bent upon itself it is ___?

A

flexed

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67
Q

f the uterus is anterior or foward flexion it is?

A

anteflexion

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68
Q

when uterus is flexed posterior or backward with flexion it is called

A

retroflexion

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69
Q

what is this

A

retroflexed

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70
Q

what is this

A

anteflexed

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71
Q

what position is tis?

A

normal

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72
Q

what position is this

A

retroverted

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73
Q

what position is this

A

anterverted

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74
Q

what are some AKA’s for the uterine tube?

A

fallopian tubes- ova ducts

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75
Q

what are some of the functions of the uterine tube?

A
  • receives the ovum from the ovary
  • sperm travels thru it to reach the ovum
  • fertilization can occur in it
  • provides nourishment for the fertilized ovum
  • transports fert. ovum to the cavity of the uterus
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76
Q

where does fertilization usually occur in the uterine tube?

A

in the ampulla

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77
Q

why is it dangerous for scar tissue to reside in uterine tubes?

A

it can impair egg movement and increase infertility or ectopic preg.

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78
Q

what is the length and diameter of the uterine tubes?

A

10-12 cm and 1cm in diameter

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79
Q

the lumen of the uterine tubes connects what two cavities?

A
  • uterine cavity
  • peritonieal cavity
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80
Q

the uterine tubes can be found enclosed in the medial 4/5th superior aspect of what ligament

A

broad ligament

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81
Q

what type of epithelium is the uterine tube lined with?

A

lined with ciliated columnar which is arranged into numerous longitudinal folds.

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82
Q

how many layers are the uterine tubes comprised of and what are they?

A
  • 3 layers
  • outer serosa layer
  • middle muscular layer
  • inner mucosa layer
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83
Q

the outer serosa layer is formed by?

A

peritoneum

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84
Q

the middle muscular layer are ____ and _____ , ______ muscle fibers

A
  • longitudinal and circular
  • smooth muscle fibers
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85
Q

the inner mucosa layer of the uterine tube includes what type of epithiliam and what is the function?

A

mucous membrane of simple ciliated columnar- provides nutrients for oocyte or developing embryonic mass- helps move the small amount of fluid and oocyte thru the tube

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86
Q

how many parts are included in the uterine tube structure and what are they?

A

3 parts

  • isthmus
  • ampulla
  • infundibulum
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87
Q

what is the pathway starting in the uterus

A

uterus- isthmus- ampulla- infundibulum

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88
Q

identify- this segment of the tube is within the wall of the uterus- in a fixed position- narrowest part of the tube- segment of the tube that is within the uterine wall and called the “interstitial portion”

A

isthmus

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89
Q

this portion of the uterine tube is lateral to the isthmus- is the widest part of the tube- and fertilization usually happens here

A

ampulla

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90
Q

this portion of the uterine tube is lateral to the ampulla- funnel shaped- overlies the ovary- largest part of the uterine tube- it includes the ostium and the fimbriae

A

infundibulum

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91
Q

this structure is the opening of the infundibulum and surrounded by fimbriae

A

ostium

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92
Q

this structure of the uterine tube has finger like processes coming off the infundibulum draped over the ovary-

A

fimbriae

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93
Q

what is the function of fimbriae-

A
  • they create current, traction to pull the egg into the tube- fimbria ovarica are the fimbriae that wrap around the ovary
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94
Q

this organ is oval, flattened, compressible, 3-5 cm long and 1-3 cm wide-thick and weigh 3-8 grams

A

ovaries

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95
Q

the ovaries have 2 parts- they are?

A

cortex and medulla

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96
Q

this portion of the ovaries is the dense outer part of the ovary- ovarian follicles are distributed thruout

A

cortex

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97
Q

this part of the ovary is looser inner part- blood vessles, lymph vessels and nerves from the mesovarioum enter here

A

medulla

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98
Q

ligaments: attaches from anterior uterine isthmus onto posterior bladder

A

vesicouterine fold- anterior ligament

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99
Q

ligament: attaches from posterior wall of uterus to upper 4th of vagina then onto anterior rectum

A

rectouterine fold- posterior ligament

100
Q

ligament: there are 2- they pass laterally from the lateral aspect of the uterus to the lateral wall of the pelvis-

A

broad ligaments

101
Q

what other ligaments or structures are included between the two leaves of the broad ligaments?

A
  • uterine tube
  • round ligament
  • ovarian ligament
  • nerves , blood vessels and lymphatics
102
Q

what is the fold of the broad ligament that contains the fallopian tube called?

A

mesosalpinx

103
Q

ovaries are attached to the posterior broad ligament by?

A

the mesovarioum

104
Q

this structure inserts on ant uterus surface, passes to pelvic side wall and traverses the inguinal canal and ends in the labium majora

A

round ligament

105
Q

this structure ligament gives little support in preventing uterine prolapse- it does aid in keeping uterus anteverted

A

round ligament

106
Q

how many uterosacral ligaments are there

A

2

107
Q

this structure ligament attaches from the anterior wall of scarum and inserts into posterioinferior uterus at approx level of the isthmus

A

uterosacral ligament

108
Q

this uterine ligament has sympathetic and parasympathtic nerve fibers that supply the uterus- provides important support for the uterus

A

uterosacral ligament

109
Q

this ligament extends from pelvic fascia on the lateral pelvic wall and inserts into the lateral portion of the cervix and vagina moving superiorly to the level of the isthums

A

cardinal ligmaments- mackenrodts

110
Q

this ligament is important for preventing uterine prolapse and supports the upper vaginal canal

A

cardinal ligaments- mackenrodts

111
Q

this ligament extends from cervix, passing anteriorly around bladder to the posterior surface of the pubic symphysis

A

pubocervical ligaments

112
Q

this ligament attaches the ovary to the superior margin of the uterus

A

ovarian ligament

113
Q

this ligament is located along the superior margin of the broad ligament

A

uterine tube ligaments

114
Q

the breast is considered what kind of tissue producing what

A

glandular tissue- milk producing tissue

115
Q

lobules are the smallest structures- this is?

A

one gland

116
Q

a lobe is

A

/several lobules attached together

117
Q

a sinus in the breast is?

A

lobes attached together through a sinus- little tubes

118
Q

a duct in the breast is _____ and where is it located?

A

series of sinuses converging- located at the nipple

119
Q

pigmented area surrounding the nipple

A

areola

120
Q

what are mongtomerys tubercles (glands)

A

bumps on the areola and nipple that contain the opening of sebaceous and sweat glands that secrete lubricating substances for the nipple

121
Q

where and what is fat for in the breast?

A

fat is between each lobe for protection

122
Q

what are the supporting ligaments of the breast?

A

suspensory ligmants of cooper

123
Q

where is the pectoralis muscles located in regards to the breast?

A

located internal to the breast tissue

124
Q

describe the progression of fetal blood circulation-

A
  • week 1-5: yolk sac produces blood
  • week 5-12 (1-3 months) fetal liver develops and begins producing blood (liver formed by 12 weeks
  • weeks 12-28 (3-6 months) fetal liver and spleen producing blood
  • week 28 and above- bone marrow begins producing blood with liver and spleen
  • prior to birth- liver and spleen stop production of blood- surge of RBC and WBC are produced before delivery
  • after birth- bone marrow takes over blood production
125
Q

-why do fetal RBC have a shorter life span- what is there size- how does this help?

A
  • shorter life span to compensated for by greater O2 and cO2 carrying capacity-
  • fetal RBC are larger than adult RBC- enables fetus to survive birthing process-
  • RBC transition from large to typical adult size by end of 2 weeks post delivery
126
Q

trace the circulation path prior to birth

A
  • oxygenated blood moves from placenta to umbilical vein—> blood bypasses liver thru the DUCTUS VENOSUS and moves into IVC—–>>from IVC blood flows into Rt atrium and into Left atrium thru the FORAMEN OVALE (does not enter lungs) ——>> left atrium- blood passes through the DUCTUS ARTERIOSUS located between the coronary trunk and aorta—–>> blood goes to brain and rest of the body- then circulates back to the umbilical artery for transport back to the placenta- the umbilical arteries carry CO2 rich blood
127
Q

after birth the umbilical arteries become?

A
  • median umbilical ligament
128
Q

after birth the umbilical vein becomes?

A

ligamentum teres

129
Q

after birth the ductus venosus becomes

A

legamentum venosum

130
Q

after birth the ductus arteriosus becomes

A

ligamentum arteriosum

131
Q

after birth foramen ovale becomes

A

fossa ovale

132
Q

by week 6 what fetal organ is formed?

A

heart

133
Q

by week 7 what fetal organ is formed?

A

genitals

134
Q

by week 8 what fetal organ is formed

A

olfactory system and face formed

135
Q

by week 12 what fetal organ system is formed

A

liver formed and kidney formed

136
Q

by week 20 what fetal organ is formed

A

eyes are formed

137
Q

by week 24 what fetal organ is formed

A

digestive system formed

138
Q

by weeks 24-28 what fetal organs are formed

A

auditory system and lungs formed

139
Q

by week 28 what fetal organ is formed

A

the brain is formed.

140
Q

what is obstetrics

A

branch of med that studys women during preg. childbirth- postpartum period

141
Q

what is gynecology

A

study of disease of female reproductive organs in

142
Q

parity

A

birth infant at term

143
Q

gravidity

A

number of total pregnancies

144
Q

abortion

A

terminate before week 20 of gestation - fetus weight less than 500g or 1 lb

145
Q

nullgravida

A

never been pregnant

146
Q

premigravida

A

one pregnancy

147
Q

multigravida

A

pregnant more than once

148
Q

parturient period

A

period of delivery during labor

149
Q

puerpera

A

period from delivery to 6 wks post

150
Q

grand multipara

A

delivered more than 6 babies

151
Q

nullipara

A

never delivered a baby

152
Q

primipara

A

delivered 1 child past 20 wks- 500g

153
Q

multipara

A

delivered more than one baby

154
Q

these would go under what type of history

A

menstrual history

155
Q

these would go under what type of hx?

A

gynecological hx

156
Q

what is the obstetric history formula

A

of preg- #of term deliveries- # of preterm delivery- # abortion- # living children

ie. G6-P4-1-1-5

157
Q

what is included in contraceptive hx?

A

current type in use- past history- any hormonal side effects

158
Q

what is included for sexual hx?

A

age of first intercourse- # of partners- sexual function problems- history of sexual abuse

159
Q

what is the purpose of the pelvic exam?

A
  • to look for abnormalities
  • ## to screen for pathologies- cervical cancer and infections
160
Q

what age should the pelvic exam be performed?

A

age 21 should be the first
30-65 every 5 years with HPV screening

161
Q

is pelvic exam to confirm pregnancy?

A

NO

162
Q

list the things done to prepare for pelvic exam

A
  • menstrual period done- cannot perform pap or pelvic exam while on period
  • douche- do not douche within 24 hours before exam
  • obtain urine sample for std or preg.
163
Q

during exam how many gloves does doctor wear- what is the patient positioning?

A

doctor has atleast one gloved hand

patient positioning is the LITHOTOMY POSITION

164
Q

in general what is the procedure of pelvic exam?

A
  • observation of external anatomy
    • external palpation
165
Q

what tool is used for the internal portion of pelvic exam?

A

inspection of cervix

pap smear

166
Q

describe the pap smear procedure

A
  1. cervical scrape
  2. vaginal pool
  3. cytobrush
167
Q

what is the classification of cervical cancer called?

A

cervical intraepithelial neoplasia classification CIN

168
Q

CIN normal means?

A

no abnormal findings

169
Q

CIN atypical means?

A

some anomlaies, not consistent with cancerous changes - come back 3 months or yearly

170
Q

what is CIN I

A

mild dysplasia- precancerous cells, abnormal epithelial cells

171
Q

what is CN II?

A

moderate dysplasia- precursor to cancer, may see small lesion on cervix

172
Q

what is CN III?

A

sever dysplasia, carcinoma, caught early enough- carcinoma in situ- confined to cervix

173
Q

when is bimanual- internal exam performed- what organs are examined?

A
  • performed after obtaining pap smear specimens
    • organs examined are- cervix, uterus, ovaries, pelvic floor muscle tone
174
Q

what are some common benign breast conditions?

A
  • fibrocystic breast disease-

fibroademona

175
Q

this disease is benighn bilateral breast disease- not a precursor for breast cancer- develops during child bearing years 30-50

A

fibrocystic breast disease

176
Q

multiple cysts- round, well defined, smooth, elastic- painful- size and pain flucturates with menstrual cycle- most painful few days before period

A

signs and symptoms of fibrocystic breast disease

177
Q

using ultrasound to detect fibrocystic breast disease help to differentiate between?

A

fluid filled cyst or solid mass

178
Q

what is the treatment for fibrocystic breast disease?

A
  • fine needle aspiration if cyst becomes too large- oral contraceptives, decreasing caffeine consumption, evening primrose oil in lotion- vit B complex, vit E and vit C
179
Q

this is a benign solid growth in breast tissue

A

fibroadenoma

180
Q

single lump- solid mass- tends to CALFICY over time- does not go away in menopause- well-defined, round mobile, painless, not affected by menstrual cycle- these are signs and symptoms of?

A

fibroadenoma

181
Q

what is the treatment for friboadenoma

A

surgical removal- may resolve on own

182
Q

how many uncommon benign breast conditions are there and what are they

A

2-

intraductal papilloma

fat necrosis

183
Q

this is a non cancerous growth within a milk duct, close to the nipple– may involve vascular tissue can have multiple papillomas develop in one breast- mc in menopausal women

A

intraductal papilloma

184
Q

what are the signs and symptoms for intraductal papilloma?

A

unilateral breast involvment- pain- swelling- NIPPLE DISCHARGE- VASCULAR DISCHARGE- BLOODY NON-BASCULAR- CLEAR

185
Q

what would be the treatment for intraductal papilloma?

A

warm compress to increase blood flow- NSAIDS for pain- if does not resolve surgery needed- biopsy

186
Q

this benign breast condition is cause by direct trauma to breast, can cause scar tissue in breast (dimpling)

A

fat necrosis

187
Q

what are the signs and symptoms of fat necrosis

A

ecchymosis- bruising- firm lump- round- pain

188
Q

what is the mc demographic for fat necrosis?

A

mc in obese women- more adipose tissue in breast

189
Q

what is treatment for fat necrosis?

A

needle aspiration and biopsy- ice for bruising- most resolve on own over time

190
Q

this breast infection occurs when milk duct becomes blocked or clogged

A

mammary duct ectasia

191
Q

who can MDE happen to- what does it cause- wht is the mc age and demographic?

A
  • can happen with lactating women who do not drink enough fluid
  • causes expansion proximal to actual blockage- becomes inflamed
    • mc in women 40-50
192
Q

MDE is not a risk factor of what?

A

breast cancer

193
Q

what are signs and symptoms of MDE (mammary duct ectasia) ?

A

nipple discharge- can be bilateral even if only in one nipple

nipple tenderness

periductal mastitis- secondary infection- inflammation, redness, pain, fever, scar, tissue over time

lump or thickening, INVERTED NIPPLE

194
Q

what is the treatment for MDE?

A

could resolve on own

secondary infection- treat with antibiotics

severe- remove the milk duct

195
Q

this infection occurs with breasfeeding and lactation- duct becomes clogged with thickened milk- cyst formation- can become infected and abscessed- cracks in breast tissue can cause secondnary infection

A

galactocele

196
Q

what is the treatment for galactocele

A

needle aspiration- opens clogged area

infection- antibiotics, some women cannot continue nursing on antibiotics-

197
Q

what is a fear when woman is on antibiotics and not able to breastfeed?

A

milk may dry up- pump 7-10 days, dump, and resume nursing

198
Q

this is an infection of breast tissue that occurs with breastfeeding- mc organism is staph aureus, enters breast through crack in skin of nipple and can enter through milk ducts- mc affects lactating women first 6 weeks after birth

A

puerperal mastitis

199
Q

what are the signs and symptoms of puerperal mastitis

A

breast pain- burning, swelling redness, fever, malaise, nipple discharge- milky with lactation or on birth control, some women week 12 of gestation are already secreting colostrum

200
Q

at what age should a BSE be conducted? and when?

A

women in their 20s should be educated regarding BSE

once a month 2-3 days after periods- (day 5 hormones are at lowest levels) post menopausal

201
Q

what are the steps for BSE> >?

A
  • supine with one hand under head
  • use index, middle and ring finger to palpate breast and armpits
  • use overlapping dime size circular motion to feel breat tissue
  • examine in the mirror- look for lumps- skin dimpling- changes in skin color or texture- nipple deformation, color change, leaks of any fluid
    • hand on hip, contract pec muscles to look for adherence
202
Q

when performing BSE- you may add pressure for what purpose

A

superficial- palpate subcutaneous tissue

light- little deeper into the tissue

firm- feel down to the ribs

203
Q

this type of cancer is the mc for women in the us

A

breast cancer

204
Q

most common presentations (2) for breast cancer are?

A
  • ductal carcinoma and lobular carcinoma
205
Q

this type of breast cancer is mc - 80% develops in duct, can have very well defined tumor or could be infiltration of surrounding tissue

A

ductal carcinoma

206
Q

this type of breast cancer develops from lobules- deeper- may be more difficult to detect early-

A

lobular carcinoma

207
Q

what are other breast cancers that can metastasize to breast?

A

pagets, inflammatory forms of breast cancer

208
Q

what are some risk factors for breast cancer?

A

family hx- higher risk with more primary and secondary members

radiation exposure

early onset of menses- and later menopause cause by birth control

never been pregnant- protectove effects of progesterone during pregnancy

obesity- estrogen is stored in adipose tissue

greater than age 50- mammograms recommended at 35 yoa

209
Q

what gene should you look for as risk factor of breast cancer?

A

BRCA1 and BRCA2 (tumor suppressors)

210
Q

this breast cancer is rare- comes from ingestion of estrogen through meats and dairy- synthetic estrogen in plastic, water and enviroment

A

male breask cancer

211
Q

what are some classic signs-symptoms of breast cancer?

A

mc sign is ORANGE PEEL appearance on skin- tickened- pitted look to skin- visible lump, retraction sign, painless palpation in early stages, increased venous pattern unilaterally, edema

212
Q

appears flat and broad

A

nipple retraction

213
Q

can be pulled out from sulcus where it hides- common abnormality, does not signal underlying disease

A

nipple inversion

214
Q

what are the stages of breast cancer?

A

TNM staging system

t- tumor

n- node (lymph node)

m metastasis

215
Q

if given Tis, N0, M0 how would you read this?

A

carcinoma in situ, no spread to nearby lymph nodes, no distant spread

216
Q

TX

A

tumor cannot be assessed

217
Q

T0

A

no evidence of primary tumor

218
Q

Tis

A

carcinoma in situ

219
Q

T1 tumor

A

less than or equal to 2 cm

220
Q

T2 tumor

A

2-5 cm

221
Q

T3 tumor

A

greater tan 5 cm

222
Q

T4 tumor

A

invaded chest wall or skin

223
Q

NX

A

nearby nodes cannot be assessed

224
Q

N0

A

no spread to nearby lymph nodes

225
Q

N1

A

spread to 1-3 axillary nodes and or to internal mammary nodes

226
Q

N2

A

spread to 4-9 axillary nodes

227
Q

N3

A

spread to 10 plus axillary mammary and or clavicular nodes

228
Q

MX

A

presence of distant spread cannot be assessed

229
Q

M0

A

no distant spread

230
Q

M1

A

spread to distant organs

231
Q

what are the early stages of breast cancer?

A

stage- 0, I, II, IIIA

232
Q

stage 0

A

non invasive- no evidence of cancer cells- no invasion

233
Q

stage I- invasive

A

tumors less or equal to 2cm- no lymph node involvement- no spread T1-N0-N0

234
Q

stage IIA- invasive

A

T0- N1, M0

T1, N1, M0

T2, N0, M0

235
Q

stage IIB invasive

A

T2, N1, M0

T3, N1-2, M0

236
Q

Stage IIIA invasive

A

T0-s, N2, M0

T3, N1-2, M0

237
Q

Stage IIIB invasive

A

T4, N0-2, M0

238
Q

stage IIIC invasive

A

T0-4, N3, M0

239
Q

stage IV- metastatic- what is the mc site for metastasis- what is the survival rate

A

lungs, liver bone, brain T0-4, N0-3, M1-

240
Q

survival rates are?

A

stage 0-I 100%

stage II 86%

stage III 57%

stage IV 20%

241
Q

what is the most common location of breast cancer?

A

50% upper outer quad

18% nipple involvement

15% upper inner quad

11% lower outer quad

6% lower inner

242
Q

what are some additional forms of breast cancer?

A

pagets

inflammatory breast cancer

breast cancer during pregnancy- mc assoc with inflammatory

bilateral breast cancer

243
Q

how do you detect breast cancer

A

palpation

mamography

dx ultra sound

needle aspiration

mri

pet scan

thermography

biopsy

ductal lavage

244
Q

what is definitive dx of breast cancer

A

must have positive cellular findings and positive mammogram

245
Q

what are some breast cancer treatments

A

lumpectomy- remove breast lump

mastectomy- lymph nodes removed

tamoxifen blocks growth of cancerous tissue- anti estrogen

surgery followed by chemotherapy and radiation

246
Q

m

A

Trimester 7 (13 decks)

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