Final Exam: NR509 / NR 509 (Latest Version
) Advanced Physical Assessment |
Questions & Correct Answers | 100%
Correct | Grade A - Chamberlain
A 35-year-old G0P0 woman presents to clinic with a complaint of bilateral nipple
discharge. This discharge started several weeks ago and has occurred at irregular
intervals since that time. She does not complain of local tenderness, redness, fever,
or any other systemic symptoms aside from slightly irregular periods over the last
few months. On examination, she is able to express a small amount of discharge,
which is sent to the laboratory and found to be consistent with breast milk but
without any signs of blood or pus. Screening laboratories are also sent, which
reveal a normal blood count, metabolic panel, thyroid-stimulating hormone, and
human chorionic gonadotropin (HCG) level. Further laboratories are still pending.
Which of the following is the most likely diagnosis? - ANSWER
Prolactinoma
A 22-year-old G0P0 undergraduate student presents to clinic after finding a breast
mass on breast self-examination (BSE) at home. The mass is nontender without
skin changes, erythema, or overlying swelling. She has heard that most breast
cancers are found by patients themselves, and she is very concerned that she may
have breast cancer. Which of the following is true about BSE and self-detection of
breast cancer? - ANSWER This patient is more likely to find a
fibroadenoma than a cancer on self-examination
48 year old psychologist concerns about breast cancer risk after an age-marched
cousin recently diagnosed. patient read about testing for breast cancer genes
(BRCA1 and BRCA2) and desires further information about whether this would be
appropriate for her. Which of the following is true about this patient's indications
for BRCA testing? - ANSWER this patient carries several risk factors
that together justify BRCA testing.
, A 68-year-old former paleontologist presents to clinic with concerns about her
breast cancer risk. Her mother developed the disease in her 50s and died from it in
her 60s. A younger cousin developed the disease a few years ago before the age of
50 years, but this individual was not tested for the BRCA1 and BRCA2 genes. In
addition, the patient suffered from lymphoma in her 20s and had radiation to the
chest. She did take hormone replacement therapy for a few years before data
emerged that this may contribute to breast cancer risk. She has had several
abnormal mammograms in her 50s for persistently dense breasts with subtle
findings, but follow-up biopsies never showed any malignant pathology. Which of
the following is true regarding magnetic resonance imaging (MRI) screening of
this patient? - ANSWER Regardless of recommendations, the high
sensitivity of breast MRI comes at the expense of markedly decreased specificity
(i.e. the ability to rule out disease in healthy breasts).
66 year old female museum curator presents for a routine annual examination. on
examination, a notably enlarged supraclavicular lymph node is appreciated on the
right side. non tender and feels firm and rubbery. denies any localized or systemic
symptoms. has been taking estrogen for 9 years since menopause. Which of the
following is true about this presentation of lymphadenopathy? - ANSWER
Metastatic breast cancer cells may spread directly into the infraclavicular and then
supraclavicular nodes without first causing notable changes in the axillary nodes.
24 year old graphic designer presents to the clinic with a concern for a breast mass.
rubbery, mobile, nontender mass is palpated in the right breast, which is consistent
with a fibroadenoma. examiner notes a 3cm mass proximal to and 3cm left of the
nipple. Which of the following would be the most appropriate way to report this
finding? - ANSWER "Rubbery, mobile, nontender mass located in the
right breast, in the 10:30 position from the nipple"
54 year old female dietician presents for a routine examination. reports has had
many breast findings over several years, including one biopsy with normal
) Advanced Physical Assessment |
Questions & Correct Answers | 100%
Correct | Grade A - Chamberlain
A 35-year-old G0P0 woman presents to clinic with a complaint of bilateral nipple
discharge. This discharge started several weeks ago and has occurred at irregular
intervals since that time. She does not complain of local tenderness, redness, fever,
or any other systemic symptoms aside from slightly irregular periods over the last
few months. On examination, she is able to express a small amount of discharge,
which is sent to the laboratory and found to be consistent with breast milk but
without any signs of blood or pus. Screening laboratories are also sent, which
reveal a normal blood count, metabolic panel, thyroid-stimulating hormone, and
human chorionic gonadotropin (HCG) level. Further laboratories are still pending.
Which of the following is the most likely diagnosis? - ANSWER
Prolactinoma
A 22-year-old G0P0 undergraduate student presents to clinic after finding a breast
mass on breast self-examination (BSE) at home. The mass is nontender without
skin changes, erythema, or overlying swelling. She has heard that most breast
cancers are found by patients themselves, and she is very concerned that she may
have breast cancer. Which of the following is true about BSE and self-detection of
breast cancer? - ANSWER This patient is more likely to find a
fibroadenoma than a cancer on self-examination
48 year old psychologist concerns about breast cancer risk after an age-marched
cousin recently diagnosed. patient read about testing for breast cancer genes
(BRCA1 and BRCA2) and desires further information about whether this would be
appropriate for her. Which of the following is true about this patient's indications
for BRCA testing? - ANSWER this patient carries several risk factors
that together justify BRCA testing.
, A 68-year-old former paleontologist presents to clinic with concerns about her
breast cancer risk. Her mother developed the disease in her 50s and died from it in
her 60s. A younger cousin developed the disease a few years ago before the age of
50 years, but this individual was not tested for the BRCA1 and BRCA2 genes. In
addition, the patient suffered from lymphoma in her 20s and had radiation to the
chest. She did take hormone replacement therapy for a few years before data
emerged that this may contribute to breast cancer risk. She has had several
abnormal mammograms in her 50s for persistently dense breasts with subtle
findings, but follow-up biopsies never showed any malignant pathology. Which of
the following is true regarding magnetic resonance imaging (MRI) screening of
this patient? - ANSWER Regardless of recommendations, the high
sensitivity of breast MRI comes at the expense of markedly decreased specificity
(i.e. the ability to rule out disease in healthy breasts).
66 year old female museum curator presents for a routine annual examination. on
examination, a notably enlarged supraclavicular lymph node is appreciated on the
right side. non tender and feels firm and rubbery. denies any localized or systemic
symptoms. has been taking estrogen for 9 years since menopause. Which of the
following is true about this presentation of lymphadenopathy? - ANSWER
Metastatic breast cancer cells may spread directly into the infraclavicular and then
supraclavicular nodes without first causing notable changes in the axillary nodes.
24 year old graphic designer presents to the clinic with a concern for a breast mass.
rubbery, mobile, nontender mass is palpated in the right breast, which is consistent
with a fibroadenoma. examiner notes a 3cm mass proximal to and 3cm left of the
nipple. Which of the following would be the most appropriate way to report this
finding? - ANSWER "Rubbery, mobile, nontender mass located in the
right breast, in the 10:30 position from the nipple"
54 year old female dietician presents for a routine examination. reports has had
many breast findings over several years, including one biopsy with normal
