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Exam 9: Breasts

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Question 1

Multiple Choice

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

A) Order computed tomography 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

E) B) and C)
F) A) and D)

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Question 2

Multiple Choice

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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

E) B) and D)
F) A) and C)

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Question 3

Multiple Choice

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A 52-year-old female complains of discharge from one breast. 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 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, erythema, and swelling of the nipple on the right breast. Which of the following diagnostic studies is indicated?

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 conditions is most likely?

A 45-year-old female patient presents in the emergency department due to multiple chest injuries resulting from 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 23-year-old woman is concerned about a mass she found on palpation. On examination of the patient, the mass feels cystic, round, and mobile with discrete borders. The diagnostic study that is recommended is:

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

Bloody breast discharge is associated with which of the following?

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

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

A 62-year-old female presents with a singular, hard, 1 cm, nontender, nonmobile 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 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:

Your 50-year-old patient has a rubbery, firm, mobile breast mass. In order to completely exclude the possibility of cancer, the triple test is necessary, which includes:

Your patient is a 64-year-old female who presents with complaints of a red, scaly rash on the 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: