EMQs in Clinical Medicine.pdf - Peshawar Medical College

148 The abdomen and surgery
60 Breast conditions
A
B
C
D
E
F
G
Paget’s disease
phyllodes tumour
mammary haemangioma
galactocele
chronic breast abscess
metastatic carcinoma of breast
benign eczema of nipple
H
I
J
K
L
M
fibroadenoma
postpartum fat necrosis
gynaecomastia
mastitis
dermatitis herpetiformis
duct ectasia
For each clinical scenario below, give the most likely cause for the clinical
findings. Each option may be used only once.
1 A 75-year-old woman presents to her GP with a breast lump in the upper outer
quadrant. On examination the lump is hard and irregular. There is axillary
lymphadenopathy.
2 A 53-year-old woman presents with nipple retraction and a greeny-yellow
discharge. Her ductogram shows dilated breast ducts.
3 A 21-year-old woman presents with a smooth, non-tender, highly mobile mass
on the upper outer quadrant of the right breast. Fine needle aspiration does not
reveal malignant features.
4 A 70-year-old woman presents with a worsening eczema-like rash overlying the
areola and nipple. The rash does not itch. On examination a palpable mass can
be felt under the rash.
5 A 26-year-old woman presents a fortnight post partum with a painful, enlarged
left breast. On examination she is pyrexial and her breast is tender and inflamed.
There are no palpable masses.
Answers: see page 174.