NR 509 - Final Exam Bate's Interactive Question Bank
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A 35-year-old G0P0 e. Prolactinoma
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
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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?
a. Mastitis
b. Ductal carcinoma in situ
c. Paget disease of the breast
d. Occult pregnancy
e. Prolactinoma
A 22-year-old G0P0 b. This patient is more likely to find a fibroadenoma than
undergraduate student a cancer on self- examination.
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?
a. Most masses that women
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find at home and bring to a
provider's attention turn out
to be malignant.
b. This patient is more
likely to find a
fibroadenoma than a
cancer on self-
examination.
c. The most likely breast mass
this patient is likely to find
in herself is an abscess
complicating underlying
mastitis.
d. Because of this patient's
age, breast masses
should not be pursued
with imaging and diagnosis
because the risk of cancer
is so low.
e. BSE is universally
recommended
because of very high
sensitivity
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A 48-year-old female d. This patient carries several risk factors that together justify
psychologist presents to BRCA testing.
clinic with concerns about
her breast cancer risk after
an age-matched cousin
was recently diagnosed
with this disease. This
cousin is the third family
member on her father's
side in as many years to
be diagnosed with breast
cancer, including the
patient's own father, who
had surgery and subsequent
treatment 3 years ago for
breast cancer. The patient
has little other knowledge of
her family history, only that
her grandparents
independently arrived
from Eastern Europe near
the end of World War II
and were among very few
members of their family
that survived the war. The
patient has read about
testing for the 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?
a. Her familial lineage is
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