Tamoxifen taken, what to add? (534/1700)

A 64 yo woman has been treated for breast cancer with tamoxifen. What other drug should be
added to her tx regime?
a. Bisphosphonates
b. Calcium
c. Vit D
d. Calcitonin
e. Phosphate binders

Side effects of tamoxifen (385/1700)

A 65yo female pt was given tamoxifen, which of the following side effect caused by it will
concern you?
a. Fluid retention
b. Vaginal bleeding
c. Loss of apetite
d. Headache and dizziness
e. Anorgasm

Breast cancer patient, confused and thirsty (382/1700)

A 50 yo woman who was treated for breast cancer 3 yrs ago now presents with increase thirst
and confusion. She has become drowsy now. What is the most likely metabolic abnormality?
a. Hypercalcemia
b. Hyperkalemia
c. Hypoglycemia
d. Hyperglycemia
e. Hypocalcemia

Breast itching, ulceration, bloody discharge (375/1700)

A 48yo lady presents with itching, excoriations, redness, bloody discharge and ulceration around her nipple. What is the most likely dx?
a. Paget’s disease of the breast
b. Fibrocystic dysplasia
c. Breast abscess
d. Duct papilloma
e. Eczema

Arm swelling following radical mastectomy (321/1700)

A 67yo female who had undergone a radical mastectomy now comes with the complaint of
swelling and redness in her right upper limb. Involvement of which of the following structures
explain these symptoms?
a. Epitrochlear LN
b. Cephalic vein
c. Subclavian artery
d. Axillary group of LN
e. Long thoracic nerve

Breast Mass (320/1700)

A 67yo woman has presented with hard, irregular, poorly defined 5cm lump in her right breast.
She has a bruise on the surface and there is no discharge. What is the most likely dx?
a. Fibroadenosis
b. Fat necrosis
c. Fibroadenoma
d. Duct ectasia
e. Ca breast

Red swollen breast with lump (267/1700)

A 45yo woman comes with red, swollen and exudating ulcer on the nipple and areola of right
breast with palpable lump under the ulcer. What do you think is causing this skin condition?

a. Inflammatory cells releasing cytokines
b. Infiltration of the lymphatics by the carcinomatous cells
c. Infiltration of the malignant skin cells to the breast tissue

Greenish nipple discharge (39/1700)

A lady presents with itching around the breast and greenish foul smelling discharge from the
nipple. She had a similar episode before. What is the most likely dx?

a. Duct papilloma
b. Duct ectasia
c. Breast abscess
d. Periductal mastitis
e. Mammary duct fistula

Breast histology: obscure recall (15/1700)

A clinical picture of breast cancer originated from the mammary duct. Biopsy was done and there were neoplastic cells found. Choose the histological picture of the cancer.

a. Neoplastic cells are arranged in small clusters occupying a space between collagen bundles (Seirrhous carcinoma)
b. Spindle cell neoplasms with margins, which infiltrate adjacent structure, fat invaded (Breast sarcoma)
c. Small cells with round nucleus and scant indistinct cytoplasm (Lobular carcinoma)

Arm swelling post LN clearance (82/1700)

A lady with breast cancer has undergone axillary LN clearance. She develops arm swelling
after being stung by a bee. What is the most likely mechanism responsible for the swelling?
a. Lymphedema
b. Cellulitis
c. Hypersensitivity reaction
d. DVT
e. Fluid retention