Deck 9: Breasts

Question 1

A 23-year-old woman is concerned about a mass she found on palpation.Upon examination of the patient,the mass feels cystic,round,and mobile with discrete borders.The diagnostic study that is recommended is:

A) CT scan
B) Mammogram
C) Biopsy
D) Ultrasound

Answer 1

Ultrasound

Question 2

Your patient is a 36-year-old woman who complains of milky discharge from both her breasts,episodes of headache,and menstrual irregularity.The patient is on no medications.Upon examination,there are no significant findings,and the patient is not pregnant,breastfeeding,or in the postpartum period.It is important to:

A) Order prolactin level
B) Obtain an MRI of head
C) Have the patient keep a menstrual cycle diary
D) Refer the patient for mammogram

Answer 2

Order prolactin level

Question 3

When examining the breasts of a 45-year-old female patient,you note nodularity throughout both breasts.There is no dominant mass,tenderness,nipple change,or skin change.Which of the following condition is most likely?

A) Multiple fibroadenomas
B) Fibrocystic breasts
C) Mastalgia
D) Mastitis

Answer 3

Multiple fibroadenomas

Question 4

Bloody breast discharge is associated with which of the following?

A) Bleeding disorder such as von Willebrand disease
B) Malignancy
C) Excessive non-steroidal anti-inflammatories
D) A and C

Question 5

Your patient has a rubbery,firm,mobile breast mass.In order to completely exclude the possibility of cancer,the triple test is necessary,which includes:

A) CT scan
B) MRI
C) Biopsy
D) All of the above

Question 6

Your patient is a 46-year-old woman suffering from psychosis complains of milky discharge from both her breasts.Upon examination,there are no significant findings and the patient is not pregnant,breastfeeding,or in the postpartum period.You should:

A) Order CT scan of head to rule out pituitary tumor
B) Obtain a complete list of the patient's medications
C) Have the patient keep a menstrual cycle diary
D) Refer the patient for mammogram

Question 7

A 12-year-old boy is brought into the clinic by his mother.The teen boy is embarrassed because he has developed breast tissue and would like to know if there is any treatment.The physical examination reveals early stages of puberty,otherwise it is normal.This presentation is:

A) Associated with a high rate of malignancy
B) Most often due to altered hormonal levels in puberty
C) Commonly indicative of pituitary tumor triggered by puberty
D) Too dense for a mammogram and requires biopsy

Question 8

A 34-year-old female who gave birth 2 weeks ago developed fever and pain in the right breast while nursing her baby.The patient has tenderness,eythema,and swelling of the nipple on the right breast.Which of the following diagnostic studies is indicated?

A) White blood cell (WBC)count
B) Breast milk culture
C) Ultrasound
D) Fine needle biopsy

Question 9

A 52-year-old female complains of discharge from one of her breasts.There is no pain,no mass,and no skin changes.The physical examination is normal.When putting pressure on the affected breast,the nipple expresses a small amount of thick,white discharge.These findings are consistent with:

A) Duct ectasia
B) Mastitis
C) Fibroadenoma
D) Fibrocystic breasts

Question 10

A 45-year-old female patient presents in the emergency department due to multiple chest injuries as a result of a motor vehicle accident.There is a palpable,tender,irregular 3 cm soft mass located in the left breast,with erythema and swelling of the breast.Which of the following is indicated?

A) Compression wrap for chest and breast trauma
B) Mammogram
C) Re-evaluation following complete resolution of obvious injuries
D) Ultrasound

Question 11

A 62-year-old female presents with a singular,hard,1 cm,non-tender,non-mobile mass in the right breast.There are no nipple or skin changes,however,you palpate an enlarged right-sided supraclavicular lymph node.The clinician should recognize these are signs of:

A) Fibroadenoma
B) Breast cyst
C) Malignancy
D) Paget's disease

Question 12

A condition that increases risk of breast cancer in a male is:

A) Pseudogynecomastia
B) BRCA1 and 2
C) Klinefelter's syndrome
D) B and C

Question 13

Your patient is a 64-year-old female who presents with complaints of a red,scaly rash on her nipple and areola of one breast.It has been present for a few months.There is no mass or nipple discharge.You should be suspicious of:

A) Contact dermatitis
B) Mastitis
C) Paget's disease
D) Eczema

Question 14

A 23-year-old female presents with episodic bilateral breast tenderness.Upon palpation,there are multiple areas of nodularity with no dominant breast mass and no tenderness,nipple,or skin changes.It is best to recommend:

A) Ultrasound of the breasts
B) Mammogram of the breasts
C) Fine needle aspiration of one nodule within a breast
D) Diary of menstrual cycle and breast symptoms

Question 15

Which of the following variables is not a component of the Gail Model?

A) Age at menarche
B) Number of breast biopsies
C) Age at first live birth
D) Number of live births