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MedEd > Breast > Flashcards

Breast Flashcards

1
Q

Differential of <30?

A

Mastitis, galactocele, benign cystic change, fibroadenoma, normal lumpy breast

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2
Q

Differentials of 30-45?

A

Benign cystic change, cyst, abscess and carcinoma, fibroadenoma

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3
Q

Differentials of 45-60?

A

Duct ectasia, carcinoma, abscess, cyst

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4
Q

Differentials >60?

A

Carcinomas

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5
Q

Time differentials?

A

Abscess and cysts = rapid

Firboadenoma and carcinoma = slow

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6
Q

What do seatbelt injuries cause?

A

Fat necrosis

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7
Q

Pain differentials?

A

Benign cystic change, acute mastitis, abscess +/- cysts

Cancer ends to be painless

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8
Q

Signs on breast?

A

peau d’orange, nipple inversion, bloody nipple, scaling, serous discharge, red erytherma, palpable lump

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9
Q

Breast cancer RFs?

A

Breat feeding, pregnancy, late menses, early menopause
PMH of existing benign disease, previous cancer and hereditary conditions
Age
Ionising radiation and smoking
Caucasian

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10
Q

What hereditary conditions to know for breast cancer?

A

Breast cancer (BRCA1/2), ovarian cancer

Klinefelters, peutz-jeghers, corden, li-fraumeni

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11
Q

How to assess brain Lump?

A

Straps need tightening
Size, shape, skin

Nipple, meNstruation, Nodes

Time, texture, tethering, temperature, trauma, tender

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12
Q

What causes mastitis and abscess?

A

Clogged ducts with milk stasis, nipple injury, bacteria enter damaged breast (staph Aureus)

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13
Q

If mastitis but no infection?

A

Duct ectasia

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14
Q

mastitis symptoms?

A

Palpable hard wedge, red and swollen

Nipples may eb cracked ana d lactation

1-2 months breastfeeding, painful and hot

Fever + general malaise

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15
Q

Abscess symptoms?

A

Palpable single lump, red swollen

Nipples may be cracked

Very painful, fluctuant, hot and often breastfeeding for a month. Difficulty sleeping

+-fever, coryzal, myalgia

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16
Q

Management of mastitis + abscess?

A

If lactating: reassure, analgesia, encourage milk and Abx only if worsening

Non-lactating: reassure, analgesia, co-amoxiclav

Abscess: referral, USS + aspiration, surgical draimage, fluid culture and Abx

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17
Q

Causative organisms of Mastitis/abscess?

A

STAPH
Strep
E.coli

Anaerobes = clostridium
TB or bartonella henselae from cats

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18
Q

What is duct ectasia?

A

Thickening of the wall of the milk duct under the nipple that can become clogged and have fluid build up

Age related cause

19
Q

Symptoms of duct ectasia?

A

Palpable lump behind the nipple

Thick, sticky discharge (white/green/black)

+-tender, solid

20
Q

Duct ectasia RFs and management?

A

menopause, smoking, obesity, 50-50YO

US +-biopsy
Conservative, abx and excision

21
Q

Fibroadenoma definition and epidemiology?

A

Benign neoplasm of the lobule fromed from stroma and glandular epithelium

20-30YO or those of reproductive age

22
Q

Symptoms of fibroadenoma?

A

Palpable lump, small, regular, round, lobular

Normal nodes

Smooth rubbery, painless, mobile and takes time to form

23
Q

RFs, IX and management for fibroadenoma?

A

Obesity, OCC<20, recent puberty

US or mammogram if >35, FNA or core biopsy if susp

Conservative or treatment

Breast mouse

24
Q

What are fibrocystic changes?

A

Benign breast condition encompassing fibrous changes, cysts and adenosis that occurs bilaterally
Premenopausal 30-50 YO

25
Q

Symptoms of fibrocystic changes?

A

Multiple small lumps, smooth, regular, bilateral, often symmetrical

Normal nippls but may fluctuate wit periods

+-tender, rubbery, fluctuant, mobile, slow growing with fluctuations

26
Q

RFs, Ix and maagement of fibrocystic changes?

A

Obesirty, nulliparity, late menopause and increased oestrogen

Ix: Us or mammogram >35, FNA = straw coloured

Conservative management of FNA if drainage needed

UOQ

27
Q

Fat necrosis symptoms?

A

+-skin retraction and thickening, irregular, red brused

+- retraction

Hard +-tender, trauma and fixed

28
Q

what is intraductal papilloma?

A

Rare benign fibroepithelial tumour formed from the lactoferous duct epithelium

30-55
Peri-post menopause

29
Q

Symptoms of intraductal papilloma?

A

No mass, full feeling, bloody or serous discharge, unilateral
+-tender and slow

30
Q

RFs, Ix and management of intraductal papilloma?

A

Peri-post menopause

US or mammogram >35yo, FNA core biopsy

Conservative or excision of the affected duct

31
Q

Breast cancer Hx and Rfs?

A

Malignant lesions in the breats with different features and behaviours.

Elderly, high oestrohen, obesity, 1st degree relative, radiation, endometrial cancer, inherited genes, early menses and late menopause

32
Q

Breast cancer examination?

A

Examination, imaging from Mmmography or USS, histology from FNA

33
Q

Contents of anterior triangle?

A

Common carotid, internal and external carotid, Ix, X, XII, thrid, parathyorid, pharynx, ansa cervicalis

34
Q

Contents of posterior triangle?

A

Xi, external jugular vein, brachial pleux trunks, subclavian artery

35
Q

Anterior triangle neck lumps?

A

Brachial cyst, carotid body tumour, carotid artery aneurysm, laryngocele

36
Q

Posterior triangle neck lumps?

A

Cystic hygroma, cervical rib, pharyngeal pouch and subclaian aneurysm

37
Q

What is a carotid body tumour?

A

Chemodectoma

Mobile side to side but not up down, slow growing, pulsatile and causes horners or dizziness

38
Q

Features of cystic hygroma?

A

Turners association, in babies and transilluminates

39
Q

Hodgkins lymphoma specifics?

A

Hurts with alcool, younger, cervical painless lymphadenopathy
B symptoms

40
Q

Non-hodgkins lymphoma specifics?

A

Older, disseminatedlymphadenopathy and B symptoms

41
Q

Cervical lymphadenitis specifics?

A

Swelling due to infection or inflammation or cancer

42
Q

Pharyngeal pouch specifics?

A

Regurgiation, dysphagia, halitosis, older

43
Q

Branchial cysts specifics?

A

Fluctuant, non tender, upper 1/3 anterior, can be intermittent with URTi,
young

44
Q

What are neck lump Ix and Mx?

A

Bloods, USS +- FNA, MRI or CT if malignant

Removal or draingage or conservative

MedEd (32 decks)

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