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33 Cards in this Set

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reasons to screen for breask ca
-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
reason for diagnostic screening
-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)
types of nipple discharge and freq of ca
-watery 45%
-sanguinous 25%
serosanguinous 12%
-serous 6%
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
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
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
Fibroadenoma
-characteristics
-most likely in what age
-TX
-easily movable, nontender
smooth, marble like

-under 40
-electively excised
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
breast cancer
-non palpable
-palpable
-found on mamo; microcalcifications, small masses

-maybe large
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
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
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
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
class. of breast biopsy tiss by risk for ca:

-slight increase risk
moderate or florid hyperplasia
papilloma
class. of breast biopsy tiss by risk for ca:

-risk increases 3-5 times
atypical hyperplasia
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
risk factors:
*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
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
what causes pms?
no one really knows but speculates it deals w/ changes in :
-estrogen, progesterone, testosterone, serotonin
does pms require a diary

does Pmdd requires affective symptoms
no

yes,
PMDD:
-symptoms assoc. w/ what part of the cycle

-cyclic hormone changes cause
-luteal phase
-changes in neurotransmitter
what is the drug of choice for pms and pmdd
ssri
when would you use GnRH agonist
for severe cases unresponsive to treatments
WHAT are the alpha herpes
hrpes simplex virus 1 and 2
variicella-zoster virus
pathway of the infectionb
-infection via oral sex, full penetration sex or touching

-dorsal root ganglia (latency period)

-recurrence through the dorsal root ganglia
which is more painful and the worst outbreak? initial or recurrent episodes?
initial
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
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
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
what are the complaints from the pts?
burning,, itching, stings
when a pt is pregnant what should they do?
be placed on antiviral therapy and consider delivery by cesearan section
when are most of the transmission done?
when the pt is asymptomatic and unaware of their status
HSV 2 presentation:
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