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Breast Hend almalki. Station 1. a young lactating female she gave a history of 24 hr tenderness and redness. a) The pic . show ?? b) the causative organism is ? c ) DDx ? d ) list 2 Rx ? e ) the affected parts r ??? nipple & the areola ???!!.
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Breast Hendalmalki
Station 1 a young lactating female she gave a history of 24 hr tenderness and redness a) The pic. show ?? b) the causative organism is ? c) DDx? d ) list 2 Rx ? e) the affected parts r ??? nipple & the areola ???!!
a- what dose the picture show?Swelling ,redness, pus discharge of the breastB- what is the causative organism?Staphylococcus aureusC- what is the differential diagnosis? Breast abscess proceeded by early phase acute mastitis D- what is the treatment?Antibiotic (dicloxacillin)needle aspiration with culture taken and if large abscess incision and drainage should be done E- what are the affected parts?Breast lobule will be affected via the nipple ,duct system and circulation
Station 2 A- name the abnormality that you see in the picture? B- what is your DDx?c- what is the 1st underlying structure that will concern us if it get attached to this lesion? D- what maneuver that done to make this lesion more clear ? E- list the groups of axillary Lymph node? f- what is the different between benign and malignant breast cancer?
A- name the abnormality that you see in the picture?Skin dimpling caused by tetheringnote :puckering is multiple dimpling of the skin(this note is from doc kurdi session)B- what is your Dx?Breast cancer c- what is the 1st underlying structure that will concern us if it get attached to this lesion? The fibrous septa (cooper`s ligament) that separate breast lobule which may block the lymphatic that run alongside them causing edema of the breast and peau d` orange apperance
D- what maneuver that done to make this lesion more clear ? Ask the patient to raise the hand above the head E- list the groups of axillary Lymph node?
There are six groups can be easily remembered by the acronym 'APICAL' -anterior, posterior,infraclavicular, central,apical and lateral : 1- anterior or medial (pectoral) 2- posterior or inferior (subscapular) 3- lateral ( humeral) 4-(central) or intermediate ( they drain from ant , post and lat then efferents drain into apical) 5- ( infraclavicular or subclavicular) 6-( apical) : the final group , receives its afferents from all other groups and from the mammary tail and its efferents form the subclavian trunk. That was the anatomical classification Surgically, axillary lymph nodes r classified into 3 levels going from lateral to medial in relation to pectoralis minor p.m. muscle: level 1 : lat to p.m. ( mainly ant , post & lat groups) , level 2 : behind p.m. Mainly ( central and some apical nodes) , level 3 : medial to p.m. ( mainly infraclavicular group+ some apical )
f- what is the different between benign and malignant breast cancer?
Station 3 *describe what u see.? *Dx? *give 3D.Dx for bloody discharge from nipple?
A- describe what you see?Retracted nippleb- what is your differential diagnosis?Congenital retraction, duct ectasia, carcinoma C- give3 differential diagnosis for bloody discharge from nipple?Intraductal Carcinoma ,Intraductal papillomaPaget’s disease
Station 4 Q. describe Q. mention 3 important points that you should ask about in the Hx (risk factors) ? Q. what is the most proper diagnosis ?
A- describe what you see?Bilateral breast enlargementb- mention 3 important points that you should ask about in the Hx (risk factors) ?*Drugs(antihistamine ,cimetidine , anabolic steroid, diuretics spironolactone,estrogen for prostatic cancer ,digoxindecreased testosterone)sign and symptoms of* liver cirrhosis or * bronchial carcinoma D -what is the most proper diagnosis ? gynaecomastia
NB Common Breast Lumps:Young Women: Fibroadenoma / AbscessPregnant : Galactocoele / abscessMiddle aged and elderly women: Cancer higher up the differential diagnosis list. Galactocele: a cystic tumour containing milk or a milky substance Galactocele is usually round and freely mobile Needle aspiration is the choice for diagnosis and treatment with large gauge needle as the content of a galactocele is thick and creamy Surgery is performed when needle aspiration is not possible or when it becomes infected.