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NR 602 Final Exam with Complete Solutions
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NR 602 Final Exam with Complete Solutions
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NR 602 Final Exam with CompleteSolutions
Fibroadenoma Correct Ans-- most common benign breast tumor
-circumscribed lesion, solid, non-cancerous, painless, slow-growing, hormone dependent,
regress after menopause, relatively moveable, non-tender
-proliferating glandular and connective elements
-giant lumps may occur
- 15-35yo
-Dx: Core biopsy or excision (definitive dx). cryoablation after dx.
- does not increase risk for brease CA
fibrocystic breast disease Correct Ans--numerous small sacs of fluid surrounded by dense
strands of fibrous tissue in the breast
- >50% of women have
- -tx: avoid caffeine, supportive bra, low-fat diet, evening primrose oil, NSAIDs/APAP, tamoxifen
if severe
Fat necrosis of the breast Correct Ans-- necrotic fat cells with lipid-filled macrophages and
neutrophils
- Sx: skin/nipple retraction, mass that is indistinguishable from cancer, tenderness (sometimes)
- mass ususally resolves after several weeks w/o treatment- if not, need biopsy
- r/t trauma/surgery of breast
Breast cancer Correct Ans--risk: family hx, white, nulliparous, first pregnancy after 30yo,
early menarche (before 12), late menopause (after 50),
- Sx: painless, firm mass with poorly delineated margins, itching, retraction, dimpling of skin,
- sx of advanced tumor: large mass, nodularity, edema, redness, skin ulceration, fixation to chest
wall, breast size change, axillary lymphadenopathy that are fixed
, - Tumor grading: TNM (1-3pts each)- 3-5pts= low grade, well-differentiated, 6-7= intermediate,
8-9= high grade, poor differentiated cells
- surgery done 1-2 weeks after biopsy
- ER + tumors= mets to bone, soft tissue & genital organs. ER -= mets to liver, lung, and brain
Paget's disease of the breast Correct Ans-- Eczematoid eruption and ulceration from the
nipple. may spread to areola
- associated with underlying cancer
- uncommon
Mammography Correct Ans-- screening to begin 40, no later than 50.
- done every 1-2 years
- continue until age 75
STDs Correct Ans--Chlamydia: purulent discharge, red, congested cervix, urethritis,
salpingitis, UTI sx,(Tx: azithromycin). NAAT test
-Trich: Foamy, greenish-white discharge, strawberry-like appearance covers the endocervix and
may extend to vaginal mucosa, double hairpin capillaries, flagellated organisms , friable, red
cervix. protozoa (Tx: metronidazole)
-Ghon: thick, creamy discharge, inflamed cervix, urethritis, UTI sx, ( Tx: Cefixime, or ceftriaxone)
- Bac. vaginosis: gray or white d/c, "clue cells", fishy odor, pH >4.5, gram stain for dx, (Tx-
metronidazole)
- Syphilis: Trep. pallidum, painless sore (indurated, papule or ulcer with raised borders) then 6
weeks later more appear, painless regional lymphadenopathy. spirochetes (Tx-penicillin
parenterally) Jarisch-herxheimer reaction
Hepatitis Correct Ans-- B: Acute, asymptomatic, may lead to chronic carrier state, vaccination
available, incubation 6w-6m. mucous membrane exposure to blood or body fluids, sx= jaundice
anorexia, RUQ pain, fatigue. Tx=supportive
- C: RNA virus, no vaccine, no sx, no tx, rarely sexually transmitted, usually parenteral route (iv
drug users), 1-3w incubation and 8-9 weeks to antibodies, 50% get cirrhosis
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