Test 1 Materials NURS 5432 Questions with Complete
Solutions
PAP smear - -start at 25year per ACS, HPV every 5 years , cotesting every 5 years,
cytology every 3 years
Breast cancer screening - -Average risk: if chest radiation therapy before 30 year,
genetic mutation of BRCA, family/pt history of CA
40-44yr: have option to start mammogram screening every year
45-54yr: SHOULD get mammogram every year
55 and up: can do every other year or q year until they are in good health to live 10 more
years
high risk: Family history of breast cancer, non-BRCA1 or BRCA2 mutation, head radiation
therapy to chest, Li-Fraumeni Syndrome, Cowden Syndrome, Banayan-Riley Ruvalcoba
syndrome
Overdiagnosis - -finding cancer that wouldn't have been a problem if you not found it
ACS recommend AGAINST MRI if cancer chance is <15%c
cervical dysplasia - -the growth of abnormal cells in the cervix
,can be premalignant cervical disease called cervical intraepithelial neoplasia (CIN)
CIN 1: mild dysplasia with low grade lesion. Cellular change in lower 1/3rd of squamous
epithelium
CIN 2: moderate dysplasia with high grade lesion. Cellular change in lower 2/3 of
squamous epithelium
CIN 3 or Carcinoma in situ: severe dysplasia with high grade lesion. Cellular change in full
thickness of squamous epithelium
-Squamous epithelium increase during pregnancy but reduces postpartum
-Endocervical curettage is contraindicated during pregnancy
-Unless cancer is identified/suspected treatment for CIN is contraindicated during
pregnancy
Digital Breast Tomosynthesis - -provides 3D images from a mammogram machine
which rotates around the breast
Fibroadenoma - -a round, firm, rubbery mass that arises from excess growth of
glandular and connective tissue in the breast
Fluctuation in size with pregnancy or menstrual cycle
NO nipple discharge
, lesions >5cm= giant fibroadenoma
Fibroadenoma Diagnosis and Treatment - -Diagnosis:
- Palpation
- Mammogram or MRI
- US to differentiate cyst from mass
- fine needle aspiration Bx
Treatment:
- Surgery
fibrocystic breast disease "nodular sensitivie breast" - -the presence of single or
multiple benign cysts in the breasts
For bilateral nipple discharge - -Check for TSH (hypothyroid), prolactin (pituitary
tumor)
-medications: spironolactone, antihypertensives, antidepressants, antidopaminergics,
estrogen OCPs, opioids, marijuana, methyldopa, H2 receptor antagonist
Breast cancer screening per ACS - -Anual between 45 and 54 years, then every two
years after age 55
Solutions
PAP smear - -start at 25year per ACS, HPV every 5 years , cotesting every 5 years,
cytology every 3 years
Breast cancer screening - -Average risk: if chest radiation therapy before 30 year,
genetic mutation of BRCA, family/pt history of CA
40-44yr: have option to start mammogram screening every year
45-54yr: SHOULD get mammogram every year
55 and up: can do every other year or q year until they are in good health to live 10 more
years
high risk: Family history of breast cancer, non-BRCA1 or BRCA2 mutation, head radiation
therapy to chest, Li-Fraumeni Syndrome, Cowden Syndrome, Banayan-Riley Ruvalcoba
syndrome
Overdiagnosis - -finding cancer that wouldn't have been a problem if you not found it
ACS recommend AGAINST MRI if cancer chance is <15%c
cervical dysplasia - -the growth of abnormal cells in the cervix
,can be premalignant cervical disease called cervical intraepithelial neoplasia (CIN)
CIN 1: mild dysplasia with low grade lesion. Cellular change in lower 1/3rd of squamous
epithelium
CIN 2: moderate dysplasia with high grade lesion. Cellular change in lower 2/3 of
squamous epithelium
CIN 3 or Carcinoma in situ: severe dysplasia with high grade lesion. Cellular change in full
thickness of squamous epithelium
-Squamous epithelium increase during pregnancy but reduces postpartum
-Endocervical curettage is contraindicated during pregnancy
-Unless cancer is identified/suspected treatment for CIN is contraindicated during
pregnancy
Digital Breast Tomosynthesis - -provides 3D images from a mammogram machine
which rotates around the breast
Fibroadenoma - -a round, firm, rubbery mass that arises from excess growth of
glandular and connective tissue in the breast
Fluctuation in size with pregnancy or menstrual cycle
NO nipple discharge
, lesions >5cm= giant fibroadenoma
Fibroadenoma Diagnosis and Treatment - -Diagnosis:
- Palpation
- Mammogram or MRI
- US to differentiate cyst from mass
- fine needle aspiration Bx
Treatment:
- Surgery
fibrocystic breast disease "nodular sensitivie breast" - -the presence of single or
multiple benign cysts in the breasts
For bilateral nipple discharge - -Check for TSH (hypothyroid), prolactin (pituitary
tumor)
-medications: spironolactone, antihypertensives, antidepressants, antidopaminergics,
estrogen OCPs, opioids, marijuana, methyldopa, H2 receptor antagonist
Breast cancer screening per ACS - -Anual between 45 and 54 years, then every two
years after age 55
