NMS Q&A Family Medicine

chapter 22Diseases of the Female BreastExamination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 A 22-year-old woman has breast cancer and is foundto be positive for BRCA1. She prefers to be tested forBRCA. If the 22-year-old woman is positive forBRCA, what is her lifetime risk of breast cancer?(A) 95%(B) 85%(C) 60%(D) 35%(E) 20%2 The 22-year-old woman has tested out positive forBRCA1. What is her lifetime risk of ovarian cancer?(A) 95%(B) 85%(C) 60%(D) 35%(E) 20%3 After breast cancer diagnosis and treatment, eachof the following should be the elements of routinefollow-up except for which one, assuming there is noevidence of residual local or metastatic cancer?(A) Physician examination every 6 months(B) Regular inspections of the ipsilateral arm foredema(C) Annual bilateral mammograms(D) Annual magnetic resonance imaging (MRI) survey(E) Monthly self-examinations4 A 45-year-old Caucasian woman complains of severalweeks of spreading non-painful erythema of theleft breast. A course of dicloxacillin had no appreciableeffect on the process. Breast examination revealsno palpable mass. Which of the following is the nextand best choice of action at this time?(A) Needle aspiration(B) Prescribe a different antibiotic(C) Biopsy(D) Mammogram(E) Ultrasound study5 Which of the following breast complaints warrantsthe closest and most persistent evaluation?(A) Bilateral nipple discharge, milky in appearance(B) Bilateral tenderness with irregular palpablemasses, cyclic in course(C) Purulent discharge, unilateral, with tenderness(D) Bilateral nipple irritation during nursing(E) Unilateral sanguineous discharge6 Nine months later, the patient referred to in Question1 returns and says that her galactorrhea has notceased. A pregnancy test is negative. Without any furtherinformation, which of the following is the mostcommon pathological cause of galactorrhea?(A) Prolactinoma(B) Gigantism(C) Thyrotoxicosis(D) Medication(E) Breast cancer7 A 32-year-old woman has bilateral nipple dischargethat is found to contain fat globules, no red or whitecells, and is established to be galactorrhea. She alsocomplains of headaches as well as diminution of herlibido and decrease in the flow and frequency of hermenses over the last 3 months. Headaches are worsein the mornings. Beta-chorionic gonadotropin levelis not elevated, and the remainder of the breastexamination is negative. The serum prolactin level iselevated at 250 ng/mL. Serum follicle-stimulatinghormone and thyroid-stimulating hormone levelsare within normal limits. Which of the following isthe logical next step?(A) Prescribe bromocriptine(B) Refer for surgery(C) Prescribe cabergoline(D) Suggest MRI with contrast(E) Suggest plain x-rays of the head8 A 43-year-old woman seeks your opinion for a breastlump that she discovered the previous week. She hasno first- or second-degree family history of breastcancer. She had a negative mammogram 2 years ago.The nodule is 2 to 3 cm in diameter. The remainder137