Advanced Physical Assessment: Exam 4
Review EXAM Questions And Verified
Answers|multiple choices| 100%
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Where is breast CA often felt? - CORRECT ANSWERS Tail of spence- upper outer quadrant
Normal adult breast description - CORRECT ANSWERS Soft
Granular
Nodular
Lumpy
Nodularity of breasts increase _____(when)___? - CORRECT ANSWERS Before menses
Benign breast enlargement, proliferation of palpable glandular tissue - CORRECT ANSWERS
Gynecomastia
Causes of gynecomastia - CORRECT ANSWERS Increased estrogen
Decreased testosterone
Medication side effects
*NOT a risk for male breast cancer
Accumulation of subareolar fat - CORRECT ANSWERS Pseudogynecomastia
Most lymphatic breast vessels drain into the - CORRECT ANSWERS Axillary nodes
Pectoral nodes drain... - CORRECT ANSWERS Anterior chest wall
Much of breast
Subscapular nodes drain... - CORRECT ANSWERS Posterior chest wall
portion of arm
Lateral nodes drain... - CORRECT ANSWERS Most of arm
Level I lymph nodes are... - CORRECT ANSWERS Palpable
Level II and III lymph nodes are... - CORRECT ANSWERS NOT as palpable
Pt is 23 yrs old with a single, 1 cm, round, firm, mobile and nontender mass. Dx? - CORRECT ANSWERS
Fibroma.
Ages 15-25, single, round, disc-like or lobular, small, mobile and nontender
NO RETRACTION SIGNS
Pt is 40 yrs old with a single, round, elastic, tender and mobile mass. Dx? - CORRECT ANSWERS
CYST
,30-50 yrs old, regress after menopause
Single or multiple, round, soft to firm, usually elastic, well-delineated, mobile, tender
Pt is 40 yrs old with a single, irregular, firm, non tender mass on breast. Retraction signs visible. Dx. -
CORRECT ANSWERS Cancer
T/F: lumps are always pathologic - CORRECT ANSWERS False. May be physiologic or
pathologic
Pt has mastalgia, what examination do you do? - CORRECT ANSWERS CBE
Focal breast pain more likely to merit dx testing --> ultrasound or mammogram
Medications associated with mastalgia - CORRECT ANSWERS Hormones, psychotropic
drugs (SSRI, haldol), spironolactone, digoxin
Discharge of milk containing fluid unrelated to pregnancy or lactation - CORRECT ANSWERS
Galactorrhea
Physiologic nipple discharge - CORRECT ANSWERS Bilateral, multiductal, prompted by
stimulation, color ranges (WHITE - YELLOW - GREEN)
Pathologic nipple discharge - CORRECT ANSWERS Bloody or serous
Unilateral
Spontaneous
Associated with mass
Occurring in women 40 or older
Most important risk factor for breast cancer is - CORRECT ANSWERS Age
Non-modifiable risk factors for breast cancer - CORRECT ANSWERS Breast, ovarian,
inherited genetic mutations
Personal hx of breast CA or lobular carcinoma in situ
High levels of endogenous hormones
Breast tissue density
Age of first full term pregnancy
Late menopause
Modifiable Risk Factors for breast cancer - CORRECT ANSWERS Breastfeeding for < 1 yr
Postmenopausal obesity
Use of HRT
Cigarrette smoking
Alcohol ingestion
Physical inactivity
Type of contraception
Pt is 51 y/o with no history of breast CA, with one affected first degree relative with breast CA. Which
assessment risk tool do you use? - CORRECT ANSWERS Gail model
, High risk pt with 2 1st degree relatives with breast cancer. Which assessment risk tools can you use? -
CORRECT ANSWERS Claus Model
BRCAPRO model
Which is a better predictor of breast CA: BRCA1 or BRCA2? - CORRECT ANSWERS BRCA1
Pts breast density is 70% of breast tissue. What are the effects? What do you do? - CORRECT ANSWERS
Higher risk of breast CA due to masking effect of breast density on smaller cancers
For dense breasts, mammograms re not enough. Do MRI
Most significant risk factors of breast CA are: - CORRECT ANSWERS Age, BRCA status, and
breast density on mammogram
Personal history of breast CA, family hx, and reproductive factors affecting duration of uninterrupted
estrogen exposure are also important
Best time for BSE - CORRECT ANSWERS 5 to 7 days after onset of menstruation
Positions for CBE - CORRECT ANSWERS Arms at sides
Arms over head
Hands pressed against hips
Leaning forward
Breast CA- underlying signs of CA - CORRECT ANSWERS 1) Breast dimpling or retraction
2)Fibrous strands attached to skin and fascia --> inward dimpling of skin
3) Asymmetry of breasts
4) Redness - can be infection or inflammatory carcinoma
5) Thickening of prominent pores
6) Nipple pulled inward
7) hard, irregular and poorly circumscribed nodules, fixed to the skin or underlying tissues
8) thickening of nipple and loss of elasticity
Eczematous nipple with rash and scaling extending to areola. Dx? - CORRECT ANSWERS
Paget's
When pressing deeply on the. Breast, a normal rib can be mistaken for .... - CORRECT ANSWERS
A hard breast mass
Tender cords upon palpation suggest... - CORRECT ANSWERS Mammary duct ectasia, a
benign but sometimes painful condition of dilated ducts with surrounding inflammation
At times, it is associated with masses
Mobile mass becomes fixed with the arm relaxes...It is attached to the... - CORRECT ANSWERS
Ribs and intercostal muscles
A mobile mass becomes fixed when the hand is pressed against the hip, it is attached to the... -
CORRECT ANSWERS Pectoral fascia
Review EXAM Questions And Verified
Answers|multiple choices| 100%
Passed!!
Where is breast CA often felt? - CORRECT ANSWERS Tail of spence- upper outer quadrant
Normal adult breast description - CORRECT ANSWERS Soft
Granular
Nodular
Lumpy
Nodularity of breasts increase _____(when)___? - CORRECT ANSWERS Before menses
Benign breast enlargement, proliferation of palpable glandular tissue - CORRECT ANSWERS
Gynecomastia
Causes of gynecomastia - CORRECT ANSWERS Increased estrogen
Decreased testosterone
Medication side effects
*NOT a risk for male breast cancer
Accumulation of subareolar fat - CORRECT ANSWERS Pseudogynecomastia
Most lymphatic breast vessels drain into the - CORRECT ANSWERS Axillary nodes
Pectoral nodes drain... - CORRECT ANSWERS Anterior chest wall
Much of breast
Subscapular nodes drain... - CORRECT ANSWERS Posterior chest wall
portion of arm
Lateral nodes drain... - CORRECT ANSWERS Most of arm
Level I lymph nodes are... - CORRECT ANSWERS Palpable
Level II and III lymph nodes are... - CORRECT ANSWERS NOT as palpable
Pt is 23 yrs old with a single, 1 cm, round, firm, mobile and nontender mass. Dx? - CORRECT ANSWERS
Fibroma.
Ages 15-25, single, round, disc-like or lobular, small, mobile and nontender
NO RETRACTION SIGNS
Pt is 40 yrs old with a single, round, elastic, tender and mobile mass. Dx? - CORRECT ANSWERS
CYST
,30-50 yrs old, regress after menopause
Single or multiple, round, soft to firm, usually elastic, well-delineated, mobile, tender
Pt is 40 yrs old with a single, irregular, firm, non tender mass on breast. Retraction signs visible. Dx. -
CORRECT ANSWERS Cancer
T/F: lumps are always pathologic - CORRECT ANSWERS False. May be physiologic or
pathologic
Pt has mastalgia, what examination do you do? - CORRECT ANSWERS CBE
Focal breast pain more likely to merit dx testing --> ultrasound or mammogram
Medications associated with mastalgia - CORRECT ANSWERS Hormones, psychotropic
drugs (SSRI, haldol), spironolactone, digoxin
Discharge of milk containing fluid unrelated to pregnancy or lactation - CORRECT ANSWERS
Galactorrhea
Physiologic nipple discharge - CORRECT ANSWERS Bilateral, multiductal, prompted by
stimulation, color ranges (WHITE - YELLOW - GREEN)
Pathologic nipple discharge - CORRECT ANSWERS Bloody or serous
Unilateral
Spontaneous
Associated with mass
Occurring in women 40 or older
Most important risk factor for breast cancer is - CORRECT ANSWERS Age
Non-modifiable risk factors for breast cancer - CORRECT ANSWERS Breast, ovarian,
inherited genetic mutations
Personal hx of breast CA or lobular carcinoma in situ
High levels of endogenous hormones
Breast tissue density
Age of first full term pregnancy
Late menopause
Modifiable Risk Factors for breast cancer - CORRECT ANSWERS Breastfeeding for < 1 yr
Postmenopausal obesity
Use of HRT
Cigarrette smoking
Alcohol ingestion
Physical inactivity
Type of contraception
Pt is 51 y/o with no history of breast CA, with one affected first degree relative with breast CA. Which
assessment risk tool do you use? - CORRECT ANSWERS Gail model
, High risk pt with 2 1st degree relatives with breast cancer. Which assessment risk tools can you use? -
CORRECT ANSWERS Claus Model
BRCAPRO model
Which is a better predictor of breast CA: BRCA1 or BRCA2? - CORRECT ANSWERS BRCA1
Pts breast density is 70% of breast tissue. What are the effects? What do you do? - CORRECT ANSWERS
Higher risk of breast CA due to masking effect of breast density on smaller cancers
For dense breasts, mammograms re not enough. Do MRI
Most significant risk factors of breast CA are: - CORRECT ANSWERS Age, BRCA status, and
breast density on mammogram
Personal history of breast CA, family hx, and reproductive factors affecting duration of uninterrupted
estrogen exposure are also important
Best time for BSE - CORRECT ANSWERS 5 to 7 days after onset of menstruation
Positions for CBE - CORRECT ANSWERS Arms at sides
Arms over head
Hands pressed against hips
Leaning forward
Breast CA- underlying signs of CA - CORRECT ANSWERS 1) Breast dimpling or retraction
2)Fibrous strands attached to skin and fascia --> inward dimpling of skin
3) Asymmetry of breasts
4) Redness - can be infection or inflammatory carcinoma
5) Thickening of prominent pores
6) Nipple pulled inward
7) hard, irregular and poorly circumscribed nodules, fixed to the skin or underlying tissues
8) thickening of nipple and loss of elasticity
Eczematous nipple with rash and scaling extending to areola. Dx? - CORRECT ANSWERS
Paget's
When pressing deeply on the. Breast, a normal rib can be mistaken for .... - CORRECT ANSWERS
A hard breast mass
Tender cords upon palpation suggest... - CORRECT ANSWERS Mammary duct ectasia, a
benign but sometimes painful condition of dilated ducts with surrounding inflammation
At times, it is associated with masses
Mobile mass becomes fixed with the arm relaxes...It is attached to the... - CORRECT ANSWERS
Ribs and intercostal muscles
A mobile mass becomes fixed when the hand is pressed against the hip, it is attached to the... -
CORRECT ANSWERS Pectoral fascia
