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If patient has nipple discharge (from an isolated duct) and no lesions are
identified by mammogram or ultrasound, you should order a : - CORRECT
ANSWER ✔✔- MRI or ductogram for further imaging, if there is an abnormality
then get tissue biopsy. If not abnormality then you can pursue a duct excision.
Alternative to duct excision is a f/u exam and imaging in 6 months
Inflammatory breast cancer pathology shows: - CORRECT ANSWER ✔✔- Dermal
lymphovascular tumor emboli
For granulomatous mastitis, you should get a biopsy sample for - CORRECT
ANSWER ✔✔- acid fast bacilli (r/o TB)
For axillary node dissection, all of the nodal tissue with level ___ of the axilla is
removed - CORRECT ANSWER ✔✔- Level I and level II (tissue inferior to the
axillary vein, and from the medial border of the pectoralis minor muscle to the
lastissimus dorsi muscle)
___% of Paget disease is associated with underlying in situ or invasive carcinoma -
CORRECT ANSWER ✔✔- 90%
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,HER2 breast cancer with hormone receptor positve can be treated with adjuvant
___ therapy post-operatively - CORRECT ANSWER ✔✔- Endocrine therapy
(Tamoxifen) to minimize occurrence...5 yrs?
On breast ultrasound, a solid mass with lobulated margins is consistent with a : -
CORRECT ANSWER ✔✔- fibroadenoma
On breast ultrasound, pleomorphic calcifications are associated with: - CORRECT
ANSWER ✔✔- in situ cancer
On breast ultrasound, ductal dilation with intraductal mass is consistent with: -
CORRECT ANSWER ✔✔- intraductal papilloma or ectasia
SLND is appropriate for almost any patient with has: - CORRECT ANSWER ✔✔-
early invasive breast cancer and without clinically palpable axillary lymph nodes
(controversy on use on large tumors >5cm)
Calcifications on screening mammogram should be further evaluated with a: -
CORRECT ANSWER ✔✔- diagnostic mammogram with magnification views and
likely a stereotiactic biopsy
___ syndrome is associated with p53 mutation - CORRECT ANSWER ✔✔- Li-
Fraumeni syndrome
Li-Fraumeni syndrome is associated with what cancers? - CORRECT ANSWER ✔✔-
Breast cancer, sarcomas, brain tumors, leukemia, and adrenocortical
malignancies.
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,The thoracodorsal nerve is responsible for - CORRECT ANSWER ✔✔- arm
adduction, arm extension, and internal rotation (innervates the latissimus dorsi)
___local inoculation of bacteria in an immunocompromised patient. Nodular
cellulitis, sometimes draining pus as well as yellow granules - CORRECT ANSWER
✔✔- Botryomycosis
Sentinel lymph node biopsy is indicated in melanomas greater than > ___ in size
or in the presence of _____ - CORRECT ANSWER ✔✔- 1mm in size or if there are
ulcerations
Initial treatment for first episode of pilonidal abscess is: - CORRECT ANSWER ✔✔-
incision and drainage. Overall success is only 60%
Skin lesions concerning for melanoma are typically greater than ___ in size -
CORRECT ANSWER ✔✔- >6mm in size
History of melanoma and new onset headaches with increasing frequency should
be investigated with: - CORRECT ANSWER ✔✔- MRI to rule out brain metastasis
Soft tissue lesions that are large and nonmobile should be evaluated with a -
CORRECT ANSWER ✔✔- MRI! (diagnostic) and then later you can get a targeted
biopsy
Immunocompromised patients are at high risk for developing aggressive SCC, risk
factors that warrant a sentinel node biopsy is a tumor diameter >___ for
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, trunk/extremities and >___ for the face, scalp, hands, and feet - CORRECT
ANSWER ✔✔- >2cm for trunk/extremities, >1cm for the face, scalp, hands, feet
Indication for antibiotics in the setting of pilonidal disease is if patient has: -
CORRECT ANSWER ✔✔- Immunosuppression, significant cellulitis, or concomitant
systemic illness
Felon is an infection extending to the ___depth in the digit. It needs immediate
incision, antibiotic therapy, to prevent vascular compromise (ischemic necrosis) -
CORRECT ANSWER ✔✔- Pulp depth
These risk factors for MRSA supports need for empiric MRSA coverage
(vancomycin) - CORRECT ANSWER ✔✔- Recent hospitalization, residence in a long
term care facility, recent surgery, Hemodialysis, and HIV infection
Routine surveillence for Stage I Liposarcoma entails physical exam every ___
months for ___years and then ____ - CORRECT ANSWER ✔✔- PE every 3-6
months for 2-3 years then annually with periodic imaging as appropriate
Routine surveillance for Stage II or Stage III liposarcoma includes pysical
examination every ___months for ___ years then every ____ for ____years -
CORRECT ANSWER ✔✔- PE every 3-6 months for 2-3 years then every 6 months
for 2 years with periodic imaging and chest
____ is a monoclonal antibody against PD-1 that has increased long-term survival
for metastatic melanoma >40%, it can be combined with ____ for dual
immunotherapy for survival >50% - CORRECT ANSWER ✔✔- Pembrolizumab and
dual therapy with ipilimumab
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