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33 Cards in this Set
- Front
- Back
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reasons to screen for breask ca
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-baseline at 35 to 40
-family hx of premenopausal bc (5yrs b4 diagnosis -annual or biannual, 40 to 50 -anual for family hx -dependent of baseline findings |
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reason for diagnostic screening
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-palpable mass in a women >35, or FAMILY HX of premeno. bc
-palpable mass, ANY AGE, doesn't yeild fluid on aspiration, doesn't resolve after menses -mass shown to be solid on sonogram -skin changes ("orange peel", dimpling) |
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types of nipple discharge and freq of ca
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-watery 45%
-sanguinous 25% serosanguinous 12% -serous 6% |
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Cyst most like in what age group
Fiibroadenoma are found in what age group mostly? Cancer risk increases with... it is most often found where? |
-40-55 age group
-most common solid in <40 -risk increases with age 1st upper outer quadrant 2nd subareolar area |
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Mastitis
-occurs when -can occur due to -s/s -tx |
-during lactation
-secondary infection (nipple trauma or irritation, breast trauma, cystic mastitis) -redness, swelling, incr. skin temp, fever -abx, heat application, milk expression, schedule follow-up |
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Intraductal Papiloma
-develops in -charac. of nipple discharge -located by what two things -tX |
-a single milk duct
-spontaneous bloody (streaked), serous, or cloudy -segmental massage (wedge) and look at discharge; more acurately by DUCTOGRAM -Excistion of affected area |
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Fibroadenoma
-characteristics -most likely in what age -TX |
-easily movable, nontender
smooth, marble like -under 40 -electively excised |
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Fibrocystic breast changes
-most likely in what age -sono will tell -if persistant, what test should be done |
-40 to 50
-if it is solid or fluid filled -aspirated for histologic diagnosis |
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breast cancer
-non palpable -palpable |
-found on mamo; microcalcifications, small masses
-maybe large |
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Detection on a mammo
-calcifications classified by... -MALIGNANT OR BENIGN TYPICALLY -..clusters or linear distribution OR scattered or diffused pattern would be more alarming |
-By morphology, size and distribution
TYPICALLY BENIGN -clusters or linear distribution would be more concerning |
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Detection on a mammo:
-density -mass: oval lobular irregular |
-change seen in ONE projection
(there are two projections: craniocaudal and mediolateral= total of 4 images -seen in TWO different projections -benign cause for concern suspiciious for cancer |
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when would you need to do a open biopsy
if you were suspiciou for microcalcificatons what techn. would you use |
when you felt a palpable mass
needle localization biopsy |
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class. of breast biopsy tiss by risk for ca:
-no increased risk |
adenosis
duct ectasia fibroadenoma fib rosis mild hyperlasia (3-4 cells deep) mastitis squamous metaplasia |
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class. of breast biopsy tiss by risk for ca:
-slight increase risk |
moderate or florid hyperplasia
papilloma |
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class. of breast biopsy tiss by risk for ca:
-risk increases 3-5 times |
atypical hyperplasia
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TX of cancer on a biopsy:
-dictated by.... -different options |
-tumor size, type, spread, estrogen and progesterone receptors
*lymph node biopsy- classical or sentinal node biopsy *mastectomy vs. lumpectomy followed by radiation *chemo *TAMOXIFEN |
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risk factors:
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*hx of breast ca (DCIS , LCIS)
*obesity, EtOH *2nd degree relative diag. w/ bc *relative diag with bc <50 y/o *use of HRT *late menopause >55 y/o *<11 at menarch *1st birth >30 or nulliparity *1st degree relative w/ bc *hx of breast biopsy *hx of atypical hyperplasia of breast |
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PMS
-what symptoms -when does it occure -when does it abait -what age does it present |
-physical, mental, and behavioral
-after ovulation, preceding menses -after the first day or two of flow -30-49 years of age |
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what causes pms?
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no one really knows but speculates it deals w/ changes in :
-estrogen, progesterone, testosterone, serotonin |
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does pms require a diary
does Pmdd requires affective symptoms |
no
yes, |
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PMDD:
-symptoms assoc. w/ what part of the cycle -cyclic hormone changes cause |
-luteal phase
-changes in neurotransmitter |
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what is the drug of choice for pms and pmdd
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ssri
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when would you use GnRH agonist
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for severe cases unresponsive to treatments
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WHAT are the alpha herpes
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hrpes simplex virus 1 and 2
variicella-zoster virus |
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pathway of the infectionb
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-infection via oral sex, full penetration sex or touching
-dorsal root ganglia (latency period) -recurrence through the dorsal root ganglia |
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which is more painful and the worst outbreak? initial or recurrent episodes?
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initial
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when is the lesions noted after infection?
when does the new lesion formation end? most pain resolved when/ |
-6days after sexual contact
-7th day after the 1st lesion is seen -15-16 days after the 1st lesion is seen |
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HSV1:
-mostly seen where? -what age group? -shorter or longer inital and recurrent outbreaks then HSV2 -can you still get HSV2? |
-orolabial (cold sores, fever bilters)
-younger sexually active pts -shorter -CAN STILL GET HSV 2 |
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HSV2:
-where -what % of recurrent genital herpes -are there more freq asymptomatic shedding then HSV1 -can you still get HSV1? |
-almost entirely GENITAL; oral rare
->95% -more freq -very low risk |
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what are the complaints from the pts?
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burning,, itching, stings
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when a pt is pregnant what should they do?
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be placed on antiviral therapy and consider delivery by cesearan section
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when are most of the transmission done?
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when the pt is asymptomatic and unaware of their status
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HSV 2 presentation:
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classic lesions
subclinical shedding- presence of symptoims such as itching or tingling without any apparent lesions AVS- presence of HSV on surface of the skin/mucosa in the absence of s/s |
