NURS 5432 TEST 1 STUDY GUIDE
PAP smear - Answers - start at 25year per ACS, HPV every 5 years , cotesting every 5
years, cytology every 3 years
Breast cancer screening - Answers - 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 - Answers - 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 - Answers - 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 - Answers - provides 3D images from a mammogram
machine which rotates around the breast
Fibroadenoma - Answers - 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 - Answers - Diagnosis:
- Palpation
- Mammogram or MRI
- US to differentiate cyst from mass
- fine needle aspiration Bx
Treatment:
- Surgery
fibrocystic breast disease "nodular sensitivie breast" - Answers - the presence of single
or multiple benign cysts in the breasts
mastoplasia - Answers - thickening of breast tissue in a ropelike manner that
predominate during menstrual cycle
Non pharm management for fibrocystic BD - Answers - Cold compress,
supportive bra 24 hours a day,
sodium restriction 10 days before onset of menstruation, decrease or eliminate caffeine,
reduce dietary fat
pharm management for fibrocystic BD - Answers - vitaminD 2000 IU day
spironolactone for swelling (25-200mg PO daily; start with 100 IU daily)
vitamin E 200 IU twice daily or 500 IU daily
evening primrose oil 2-4g daily
oral contraceptives
Intraductal papilloma (IDP) - Answers - Benign tumor within the ductile system (ductal
epithelium and myoepithelial cells) of the breast that may occur alone or as multiple
tumors. Most common in women ages 35 to 50 years. Ductal ectasia is often associated
with IDP
For bilateral nipple discharge - Answers - 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 - Answers - Anual between 45 and 54 years, then
every two years after age 55
Breast Cancer - Answers - 2nd most cause of CA death in USA women
Malignant neoplasm of cells native to breast epithelial, glandular, or stoma
Hormone replacement therapy is a RISK FACTOR for Breast CA - Answers -
(combination estrogen-progestrone and estrogen only agent)
during perimenopause increases breast cancer risk for 10 years after medication
discontinued
PAP smear - Answers - start at 25year per ACS, HPV every 5 years , cotesting every 5
years, cytology every 3 years
Breast cancer screening - Answers - 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 - Answers - 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 - Answers - 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 - Answers - provides 3D images from a mammogram
machine which rotates around the breast
Fibroadenoma - Answers - 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 - Answers - Diagnosis:
- Palpation
- Mammogram or MRI
- US to differentiate cyst from mass
- fine needle aspiration Bx
Treatment:
- Surgery
fibrocystic breast disease "nodular sensitivie breast" - Answers - the presence of single
or multiple benign cysts in the breasts
mastoplasia - Answers - thickening of breast tissue in a ropelike manner that
predominate during menstrual cycle
Non pharm management for fibrocystic BD - Answers - Cold compress,
supportive bra 24 hours a day,
sodium restriction 10 days before onset of menstruation, decrease or eliminate caffeine,
reduce dietary fat
pharm management for fibrocystic BD - Answers - vitaminD 2000 IU day
spironolactone for swelling (25-200mg PO daily; start with 100 IU daily)
vitamin E 200 IU twice daily or 500 IU daily
evening primrose oil 2-4g daily
oral contraceptives
Intraductal papilloma (IDP) - Answers - Benign tumor within the ductile system (ductal
epithelium and myoepithelial cells) of the breast that may occur alone or as multiple
tumors. Most common in women ages 35 to 50 years. Ductal ectasia is often associated
with IDP
For bilateral nipple discharge - Answers - 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 - Answers - Anual between 45 and 54 years, then
every two years after age 55
Breast Cancer - Answers - 2nd most cause of CA death in USA women
Malignant neoplasm of cells native to breast epithelial, glandular, or stoma
Hormone replacement therapy is a RISK FACTOR for Breast CA - Answers -
(combination estrogen-progestrone and estrogen only agent)
during perimenopause increases breast cancer risk for 10 years after medication
discontinued
