1 | P a g e [ G e n e r a l S u r g e r y ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
Plab1keys.com
Strict Copyrights!
General
No Sharing or Copying
Surgery
Allowed by any means
Compensations and
Penalties Worldwide
System is Active
Version 5.3
PLAB 1 Keys is for PLAB-1 and UKMLA-AKT (Based on the New MLA Content-Map)
Corrected, Updated, Lighter
With the Most Recent Recalls and the UK Guidelines
PLAB 1 Keys is For PLAB and UKMLA-AKT (Based on the New MLA Content-Map)
ATTENTION: This file will be updated online on our website frequently!
(example: Version 2.7 is more recent than Version 2.6, and so on)
Key Paget’s Disease of the breast and nipple
1
◙ A rare breast malignancy.
◙ With a better prognosis than the infiltrating ductal carcinoma.
◙ Features:
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,2 | P a g e [ G e n e r a l S u r g e r y ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
♠ Dry skin around the areola resembling eczema with scales + erosions.
♠ Itching in the area.
♠ Discharge per nipple sometimes bloody.
♠ Ulcerated and/or inverted nipple.
◙ Diagnosis → Punch Biopsy
Differential Diagnoses of Breast Lesions
1 ◙ Painful, fluctuating mass over the breast or near the nipple
→ Nipple Abscess (Pus Collection).
2 ◙ Brown/ Green/ Coloured discharge per Nipple → Duct Ectasia.
3 ◙ Hx of Trauma to the Breast (redness or bruises around the lump) + firm,
round, solitary and localized lump.
→ Fat Necrosis.
4 ◙ Bleeding per nipple in 20-40 YO ♀ ± skin changes
→ Ductal Papilloma → Galactogram.
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5 ◙ Bleeding discharge per nipple in an Old woman with eczema-like changes in
the nipple ± areola ± Ulcers
→ Paget’s disease (Malignant) → Punch Biopsy
6 ◙ Firm, non-tender, mobile mass in a breast of a young ♀ (15-30 YO)
→ Fibroadenoma → Clinical + Ultrasound + FNA
7 ◙ Breast pain (Mastalgia), ↑ breast size, lumpiness (nodularity) of the breast,
♀ in the reproductive age ± tend to appear just before or during menstrual cycle
and disappear after it → Fibroadenosis.
8 ◙ Fixed, irregular, hard, painless lump ± nipple retraction ± fixed to skin (Peau
d’orange) or muscle (+) Local fixed, firm axillary LNs.
→ Breast Cancer → Core biopsy
9 ◙ Offensive yellow discharge from an area near the nipple + Hx of Abscess
near this area → Ductal Fistula (Mamillary Fistula).
10 ◙ Prolonged Redness around the areola. Hx of using antibiotics which
improved symptoms slightly. Greenish discharge per nipple. ± nipple retraction
± small lump around the nipple is felt.
→ Periductal mastitis. (Commonly young age, smoking is a risk factor, treated
with antibiotics, if left untreated it may develop into an abscess that needs
drainage by fine needle).
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11 ◙ Persistent nipple discharge that is non-bloody and occasionally milky or
serous fluid. It is spontaneous. No breast masses. No Nipple retraction. No skin
changes.
→ Mamillary duct fistula (abnormal connection between lactiferous ducts of
the breast and skin surface → leads to spontaneous nipple discharge that is not
purulent nor bloody. It can appear as a milky or serous fluid).
Key Dysphagia + Regurgitation of Stale food/fluid + Chronic Cough (esp.
2 Nocturnal) ± Bad mouth breath (Halitosis) ± Aspiration ± Gurgling
sounds in the chest on drinking ± Neck lump
→ Pharyngeal pouch (Zenker’s Diverticulum)
Note: Stale food = Decayed,
rotten and old food (this is
because it has been stored in
the pouch until it has become
rotten “with bad smell”).
Copyrights @ Plab1Keys.com
Plab1keys.com
Strict Copyrights!
General
No Sharing or Copying
Surgery
Allowed by any means
Compensations and
Penalties Worldwide
System is Active
Version 5.3
PLAB 1 Keys is for PLAB-1 and UKMLA-AKT (Based on the New MLA Content-Map)
Corrected, Updated, Lighter
With the Most Recent Recalls and the UK Guidelines
PLAB 1 Keys is For PLAB and UKMLA-AKT (Based on the New MLA Content-Map)
ATTENTION: This file will be updated online on our website frequently!
(example: Version 2.7 is more recent than Version 2.6, and so on)
Key Paget’s Disease of the breast and nipple
1
◙ A rare breast malignancy.
◙ With a better prognosis than the infiltrating ductal carcinoma.
◙ Features:
Copyrights @ Plab1Keys.com
,2 | P a g e [ G e n e r a l S u r g e r y ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
♠ Dry skin around the areola resembling eczema with scales + erosions.
♠ Itching in the area.
♠ Discharge per nipple sometimes bloody.
♠ Ulcerated and/or inverted nipple.
◙ Diagnosis → Punch Biopsy
Differential Diagnoses of Breast Lesions
1 ◙ Painful, fluctuating mass over the breast or near the nipple
→ Nipple Abscess (Pus Collection).
2 ◙ Brown/ Green/ Coloured discharge per Nipple → Duct Ectasia.
3 ◙ Hx of Trauma to the Breast (redness or bruises around the lump) + firm,
round, solitary and localized lump.
→ Fat Necrosis.
4 ◙ Bleeding per nipple in 20-40 YO ♀ ± skin changes
→ Ductal Papilloma → Galactogram.
Copyrights @ Plab1Keys.com
,3 | P a g e [ G e n e r a l S u r g e r y ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
5 ◙ Bleeding discharge per nipple in an Old woman with eczema-like changes in
the nipple ± areola ± Ulcers
→ Paget’s disease (Malignant) → Punch Biopsy
6 ◙ Firm, non-tender, mobile mass in a breast of a young ♀ (15-30 YO)
→ Fibroadenoma → Clinical + Ultrasound + FNA
7 ◙ Breast pain (Mastalgia), ↑ breast size, lumpiness (nodularity) of the breast,
♀ in the reproductive age ± tend to appear just before or during menstrual cycle
and disappear after it → Fibroadenosis.
8 ◙ Fixed, irregular, hard, painless lump ± nipple retraction ± fixed to skin (Peau
d’orange) or muscle (+) Local fixed, firm axillary LNs.
→ Breast Cancer → Core biopsy
9 ◙ Offensive yellow discharge from an area near the nipple + Hx of Abscess
near this area → Ductal Fistula (Mamillary Fistula).
10 ◙ Prolonged Redness around the areola. Hx of using antibiotics which
improved symptoms slightly. Greenish discharge per nipple. ± nipple retraction
± small lump around the nipple is felt.
→ Periductal mastitis. (Commonly young age, smoking is a risk factor, treated
with antibiotics, if left untreated it may develop into an abscess that needs
drainage by fine needle).
Copyrights @ Plab1Keys.com
, 4 | P a g e [ G e n e r a l S u r g e r y ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
11 ◙ Persistent nipple discharge that is non-bloody and occasionally milky or
serous fluid. It is spontaneous. No breast masses. No Nipple retraction. No skin
changes.
→ Mamillary duct fistula (abnormal connection between lactiferous ducts of
the breast and skin surface → leads to spontaneous nipple discharge that is not
purulent nor bloody. It can appear as a milky or serous fluid).
Key Dysphagia + Regurgitation of Stale food/fluid + Chronic Cough (esp.
2 Nocturnal) ± Bad mouth breath (Halitosis) ± Aspiration ± Gurgling
sounds in the chest on drinking ± Neck lump
→ Pharyngeal pouch (Zenker’s Diverticulum)
Note: Stale food = Decayed,
rotten and old food (this is
because it has been stored in
the pouch until it has become
rotten “with bad smell”).
Copyrights @ Plab1Keys.com
