Post-Mastectomy Oedema Quiz BFOM 39

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Questions and Answers

Which condition is associated with chronic pelvic congestion?

Chronic inferior vena-cava obstruction

Chronic pelvic congestion (correct)

Chronic superior vena-cava obstruction

Chronic portal hypertension

What characterizes soft pitting edema in a patient with chronic venous insufficiency?

Soft pitting edema with pigmentation and eczema (correct)

Soft pitting edema without pigmentation and eczema

Hard pitting edema without pigmentation and eczema

Hard pitting edema with pigmentation and eczema

How would an infected venous ulcer typically present?

Painful superficial ulcer with absent peripheral pulsations

Painless deep ulcer with absent peripheral pulsations

Painless superficial ulcer with skin pigmentation around it

Painful superficial ulcer with skin pigmentation around it (correct)

What is the main treatment for acute lipodermatosclerosis?

Anti-inflammatory drugs and external compression Signup and view all the answers

Which description best applies to a healing ulcer?

Small ulcer with undermined edge and red granulating floor Signup and view all the answers

Which of the following findings from a mammogram indicate a benign condition?

Coarse calcifications Signup and view all the answers

Which factor has not been shown to increase a woman's risk for breast cancer?

Smoking Signup and view all the answers

What should a patient with positive estrogen receptors (ER+) in an invasive breast carcinoma be informed about?

ER and PR status should be assessed in all breast carcinoma cases Signup and view all the answers

What characteristic is common in cystosarcoma phyllodes?

Large polygonal cells with abundant cytoplasm Signup and view all the answers

What indicates that a solid tumor of the breast may require a biopsy?

Presence of irregular edges or growth Signup and view all the answers

Which statement regarding fine, clustered calcifications is correct?

They require further investigation due to potential malignancy. Signup and view all the answers

Which of the following statements is true regarding ER and PR status?

ER+ status often correlates with a better prognosis. Signup and view all the answers

What is a notable characteristic of inflammatory carcinoma?

Presence of extensive lymphoid infiltration Signup and view all the answers

What is the best surgical option for a patient with a palpable axillary lymph node and diffuse calcifications throughout the breast?

Modified radical mastectomy Signup and view all the answers

For a premenopausal woman with clear margins and node-positive invasive cancer, what is the recommended adjuvant therapy?

Chemotherapy, radiotherapy, and tamoxifen Signup and view all the answers

What should a pregnant woman with breast cancer be informed regarding chemotherapy during pregnancy?

Chemotherapy can begin only after the first trimester. Signup and view all the answers

What is the status of breast cancer as a cancer diagnosis during pregnancy?

It is the most common cancer during pregnancy. Signup and view all the answers

Which of the following statements is true regarding the management of breast cancer in a pregnant patient?

Mastectomy is often preferred if radiotherapy is needed. Signup and view all the answers

What has been determined about radical mastectomies in modern breast cancer treatment?

They are only performed if there is gross muscle invasion. Signup and view all the answers

In the case of node-positive invasive cancers, what is recommended in relation to adjuvant chemotherapy?

It is advised for all invasive cancers exceeding 1 cm. Signup and view all the answers

What might be a common misconception about breast cancer in pregnancy?

Most breast cancers are hormone receptor positive. Signup and view all the answers

Which surgical intervention is considered the classical treatment for acute limb ischemia?

Popliteal-to-distal bypass Signup and view all the answers

Identify the site that does NOT typically contribute to embolic ischemia in the lower limb.

The deep veins from extensive lower limb DVT Signup and view all the answers

Which of the following is NOT a common contributing factor for foot ulcers in diabetic patients?

Exaggerated inflammatory response to infection Signup and view all the answers

What is the first action to take when a diabetic patient presents with gangrene of a toe?

Look for pedal pulses Signup and view all the answers

Upon diagnosing acute lower limb ischemia, what is the immediate step to take?

Administer heparin Signup and view all the answers

Which of the following is NOT included in the triad of Leriche Syndrome?

Bilateral feet parathesia Signup and view all the answers

In which condition is catheter directed thrombolysis NOT appropriate?

Cerebral stroke history one and a half months ago Signup and view all the answers

Which of the following scenarios does NOT lead to acute limb ischemia?

Acute hemolysis of RBCs in spherocytosis Signup and view all the answers

Which sign is most indicative of irreversible ischemia that may necessitate amputation?

Loss of foot superficial and deep sensation Signup and view all the answers

Reconstructive arterial surgery should NOT be recommended for which of the following conditions?

Ischemic neuropathy Signup and view all the answers

Which statement about post-mastectomy arm oedema is false?

Is always transient. Signup and view all the answers

What does neo-adjuvant therapy mean?

Giving chemo and/or radiotherapy before surgery. Signup and view all the answers

Which is the most significant risk factor when screening females for breast carcinoma?

More than 2 first degree relatives with ovarian or breast carcinoma. Signup and view all the answers

Which of the following is NOT a characteristic association of mammographic lesions with malignancy?

Large and coarse calcifications. Signup and view all the answers

What is true about breast ultrasound?

All of the above. Signup and view all the answers

Which statement regarding MRI breast imaging is true?

All of the above. Signup and view all the answers

Which statement about breast FNAC is false?

Invasive cancer can be diagnosed from in situ disease. Signup and view all the answers

What is true about breast abscess treatment?

Rare during lactation; incision and drainage > antibiotics. Signup and view all the answers

Study Notes

Post-Mastectomy Arm Oedema

Arm oedema after mastectomy may not always be transient; some cases can become chronic.
Radiotherapy post-lymph node clearance heightens oedema risk.
Rough dissection of the axillary vein during surgery contributes to oedema.
Inserting an IV line in the affected upper limb is a risk factor for developing oedema.

Acute Hypercalcaemia in Breast Cancer

Parathyroid hyperplasia can lead to acute hypercalcaemia.
Treating hypercalcaemia at home may be less effective compared to medical settings.
Bilateral lower limb oedema is not a constant feature of hypercalcaemia.
IV fluid administration assists in managing acute hypercalcaemia.

Neo-Adjuvant Therapy

Refers to administering chemotherapy or radiotherapy before surgery.

Breast Cancer Screening Risks

Significant screening risk includes a family history of breast or ovarian carcinoma.
More than two first-degree relatives with breast cancer heightens screening concerns.
Previous breast biopsies, even benign, can indicate increased risk for breast cancer.

Breast Lymphatic Drainage

Breast lymphatics drain into axillary, internal mammary, pectoral, and subscapular nodes.

Breast Ultrasound Benefits

Effective in localizing impalpable breast lumps and differentiating solid from cystic lesions.
More beneficial than mammograms in young women with dense breast tissue.

Mammographic Lesions and Malignancy

Large and coarse calcifications typically signal benign conditions.
Thickened epidermis and poorly defined mass lesions are associated with malignancy.
Fine stippled calcifications are indicative of potential malignancy.

MRI in Breast Imaging

MRI can distinguish scar tissue from cancer recurrence.
Considered the gold standard imaging method for breast implants.

Fine Needle Aspiration Cytology (FNAC) in Breast

Safe, reliable, and minimally invasive for cell diagnosis but may miss invasive cancer in situ cases.

Breast Abscess Treatment

Management typically involves incision and drainage rather than solely antibiotics.
Commonly unilocular, requiring appropriate surgical intervention.

Cystosarcoma Phyllodes

A slow-growing tumor with a favorable prognosis if adequately treated (e.g., mastectomy).
Characterized by large polygonal cells and lymphoid infiltration.

Benign Mammography Findings

Discrete, stellate masses and coarse calcifications are typically benign.
Suspicious findings needing biopsy include solid tumors with irregular edges or size changes.

Risk Factors for Breast Cancer

Smoking has not been significantly linked to increased risk of breast cancer.
Atypical pathology from previous biopsies and family history escalate risk.

Estrogen Receptor Status in Invasive Carcinoma

Positive estrogen and progesterone receptors indicate a better prognosis and suitability for antiestrogen therapy.
ER and PR status should be assessed in all breast cancer cases.

Surgical Options in Breast Cancer

Patient with palpable axillary lymph node and DCIS stage should consider total mastectomy with sentinel lymph node biopsy, avoiding sentinel biopsy alone.

Recommended Adjuvant Therapy

For node-positive invasive carcinoma, chemotherapy, radiotherapy, and tamoxifen are advisable post-surgery.

Breast Cancer During Pregnancy

Most common cancer diagnosed in pregnancy; surgery is generally required.
Chemotherapy can begin after the first trimester; radiotherapy is postponed until after delivery.

Acute Limb Ischemia Management

Initial assessment includes evaluating pedal pulses and potentially amputation in severe cases of gangrene.
Surgical intervention may include catheter-directed embolectomy if indicated.

Chronic Venous Insufficiency

Presents as soft or hard pitting edema with associated pigmentation and eczema.
Infected venous ulcers typically present as painful, superficial ulcers with pigmentation.

Acute Lipodermatosclerosis Treatment

Managed primarily with anti-inflammatory drugs and external compression to reduce inflammation and swelling.

Healing Ulcer Characteristics

Healing ulcers are typically characterized by small size, undermined edges, and a red granulating floor.

Complications of Varicose Veins

Primary varicose veins can lead to acute superficial thrombophlebitis, highlighting the importance of monitoring venous health.

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Description

Test your knowledge on the factors influencing post-mastectomy arm oedema with this quiz from BFOM 39. Evaluate your understanding of the relationship between surgical procedures and oedema risk, as well as other related complications. Dive deep into key statements and identify the exceptions.