BREAST PATHOLOGY MCQS

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BREAST PATHOLOGYMCQS1) : The most important factor in breast enlargement during pregnancy isA. stromal edemaB. secretion of chorionic gonadotropinC. glandular hyperplasiaD. proliferation of stromaE. increased secretion of oxytocin2) The increase in breast size during adolescence is predominantly the result of: proliferation ofA. lactiferous ductsB. intralobular ductsC. glandsD. stromaE. blood vessels3) : A painless breast lump suggests each of the following exceptA. mastitisB. fibrocystic diseaseC. fibroadenomaD. carcinomaE. intraductal papilloma4) Developmental alterations of breast tissue whose gross appearance may be confused: with carcinoma includeA. polytheliaB. polymastiaC. inversion of nipplesD. vulvar mass

5) Congenital inversion of the nipples is a clinically significant developmental abnormality: becauseA. it may be confused with nipple retraction produced by carcinomaB. it is frequently associated with ovarian dysfunctionC. it is associated with an increased incidence of mammary dysplasiaD. it is an important predisposing condition to carcinoma of the breast6) : Fat necrosis of the breast is characterized by all of the following exceptA. is most frequent in obese women with pendulous breastsB. may simulate neoplasia clinicallyC. may be related to traumaD. is frequently associated with the development of carcinoma of the breast7) Histologic examination of an indurated breast lesion shows dilated ducts containingnecrotic debris and foamy macrophages and surrounded by lymphocytes, plasma cells,: and histiocytes. The best diagnosis isA. fibrocystic diseaseB. abscessC. plasma cell mastitisD. Paget’s diseaseE. comedocarcinoma8) Features common to both acute mastitis and comedomastitis (plasma cell mastitis): include each of the following exceptA. usually unilateralB. tender to palpationC. produce skin retractionD. present as a mass9) : The most common breast lesion in women isA. fibroadenomaB. carcinoma of the breastC. fibrocystic disease

D. ductal papilloma10) ?Of the following, which best characterizes fibrocystic disease of the breastA. predominantly a disease of women under 30B. multicentric originC. subareolar locationD. response to excess progesterone stimulationE. seldom associated with malignancy11) Which one of the following lesions usually presents as a discrete, freely movable?nodule in the breastA. sclerosing adenosisB. cystic diseaseC. ductal carcinomaD. fibroadenomaE. plasma cell mastitis12) A 35-year-old woman noted a lump in the breast which seemed to be enlarging. The: breast was biopsied primarily to excludeA. mastitisB. carcinoma of the breastC. fibroadenoma of the breastD. fibrocystic disease of breastE. metastatic carcinoma13) Microscopically, a breast lesion is composed of dense collagenous stroma containingsmall nests and rows of cells that form rudimentary acinar structures. The cells are roundor polygonal and contain hyperchromatic nuclei. Occasional mitoses are present. At themargins of the lesion nests of cells infiltrate fibroadipose tissue. The description applies: toA. fibroadenomaB. fibrocystic diseaseC. infiltrating ductal carcinomaD. medullary carcinoma

E. Paget’s disease with intraductal carcinoma14) A lesion from the breast of a 60-year-old woman contains a firm area 3 cm in diameterwith irregular, ill-defined margins. The lesion is densely fibrous and gritty. The sectionedsurface is gray, slightly depressed and opaque. Cords of fibrotic tissue extend irregularly: into surrounding adipose tissue. The most likely diagnosis isA. fat necrosisB. fibrocystic diseaseC. infiltrating ductal carcinomaD. medullary carcinomaE. colloid carcinoma15) Bleeding from the nipple in a 45-year-old woman, without a palpable breast mass: should suggestA. fibroadenomaB. sclerosing adenosisC. fat necrosisD. intraductal papillomaE. chronic cystic mastitis16) : Paget’s disease of the nipple presupposes the existence ofA. ductal carcinomaB. simple eczemaC. lobular carcinomaD. abnormal estrogen stimulationE. sclerosing adenosis17) The most common breast neoplasm (benign or malignant) found in young females (age: 20—35) isA. duct papillomaB. adenocarcinomaC. fibroadenomaD. sarcoma

E. Paget’s disease of the breast18) : Paget’s disease of the nipple has all of the following characteristics exceptA. is a neoplastic breast disease involving the epidermisB. histologically shows characteristic large clear cellsC. is part of the picture of long standing fibrocystic diseaseD. is associated with intraductal carcinoma19) Longstanding fat necrosis can be distinguished from breast carcinoma by the presenceofA. calcification on mammographyB. indurationC. skin retractionD. tendernessE. the cytology of fine needle aspiration20) : All of the following are associated with an increased risk of breast cancer exceptA. a previous mastectomy for cancerB. a maternal history of breast cancerC. breast feedingD. increasing age beyond 50 years21) : Carcinoma of the breast is commonly associated with all of the following exceptA. calcification as seen on mammographyB. a frequency of multicentricity above 10%C. axillary lymph node metastasisD. osteoblastic bone metastasesE. hormone production by tumor22 : Breast cancer is suggested by physical findings which include all of the following exceptA. skin dimplingB. alterations of breast contourC. edema of the skin

D. nipple inversionE. pain on palpation23) : Breast lesions which may produce skin retraction include each of the following exceptA. apocrine metaplasiaB. invasive ductal carcinomaC. subacute mastitisD. plasma cell mastitisE. fat necrosis24) A 50-year-old woman presents with persistent soreness of the nipple of the rightbreast. A crusted red, eczematous rash is present on the areola of the right breast. The: management of choice would beA. antibioticsB. biopsy of the nippleC. cortisone creamD. observation without specific treatmentE. simple mastectomy: 25) The most common location for carcinoma of the breast isA. upper inner quadrantB. lower inner quadrantC. upper outer quadrantD. lower outer quadrantE. subareola and nipple26) ?Which descriptive feature best fits fibroadenomas of the breastA. associated with Paget’s diseaseB. slowly invasiveC. nipple dischargeD. high potential for malignancyE. usually solitary

27) A feature which distinguishes inflammatory carcinoma of the breast from other breast: carcinomas isA. cured by antibioticsB. relatively favorable prognosisC. obstruction of dermal lymphatics by neoplasmD. history of trauma to the breastE. marked lymphocyte response28) Factors predisposing to the development of breast cancer in women include each of: the following exceptA. a maternal history of breast cancerB. early first pregnancyC. fibrocystic disease of the breastD. increasing age beyond 50 yearsE. previous mastectomy for cancer29) : Of the following breast lesions, which is most characteristically bilateralA. fat necrosisB. fibroadenomaC. intraductal papilloma of nipple ductsD. lobular carcinoma-in-situE. Paget’s disease30) Each of the following is a typical feature of breast carcinoma as it grows and spreads: exceptA. retraction of the nippleB. enlargement of axillary lymph nodesC. bone painD. lung metastasesE. hormone production

31): Fibroadenoma of the breast is likely toA. require radical mastectomyB. develop in elderly womenC. be fixed to the overlying skinD. occur as a solitary freely movable mass32) A 60-year-old woman comes to your office for evaluation of a breast “lump.” About 4months ago she noticed a “hard” but painless area along the lateral aspect of her leftbreast. She has previously had minor chest trauma and thought the lump was a scar. Shestates that this hard area is now larger than when she first noticed it. There is a 5 cm firmarea in the upper outer quadrant which seems firmly attached to the chest wall. Theoverlying skin is dimpled but the mass is painless. There is a firm 2 cm nodule in the left: axilla and her left arm is swollen. The most likely diagnosis isA. traumatic fat necrosis)B. comedomastitis (plasma cell mastitisC. mammary dysplasiaD. Paget’s disease of breastE. inoperable breast cancer33) Conditions associated with increased risk of breast cancer include all of the following: exceptA. a previous mastectomy for cancerB. fibrocystic disease with severe epithelial hyperplasiaC. a maternal history of breast cancerD. early pregnancies and breast feeding: 34) Classically, a fibroadenoma of the breast isA. more likely to be found in women over 40B. a solitary, slow growing, small, firm mobile breast massC. associated with the development of breast cancerD. composed of anaplastic epithelium

35) A 24-year-old woman developed a breast lump which had been first noted fourmonths before she sought a medical opinion. The tumor was well defined and seemed?discrete. What is the most likely diagnosisA. fibrocystic diseaseB. fibroadenomaC. sclerosing adenosisD. ductal carcinomaE. medullary carcinoma36) ?Which breast lesion is most commonly bilateralA. intraductal carcinomaB. medullary carcinomaC. tubular carcinomaD. in situ lobular carcinoma37) Each of the following is considered a risk factor in the development of breast: carcinoma exceptA. early menarcheB. oral contraceptive useC. nulliparityD. previous breast cancerE. familial history of breast cancer38) A 22-year-old woman presents with a discrete upper/outer quadrant breast mass. The: most likely diagnosis isA. carcinomaB. fat necrosisC. fibroadenomaD. fibrocystic diseaseE. intraductal papilloma39): The breast carcinoma with the worst prognosis isA. infiltrating ductal carcinoma

B. medullary carcinomaC. mucinous (colloid) carcinomaD. papillary carcinomaE. tubular carcinoma40)Which of the following breast lesions are believed to be induced by imbalance of?estrogen and progesterone stimulationA. fat necrosisB. plasma cell mastitisC. gynecomastiaD. fibrocystic disease: 41)In patients with breast cancer, poor prognostic signs include all the following exceptA. edema of breast skinB. fixation of tumor to chest wallC. metastases to 3 axillary lymph nodesD. presence of estrogen receptors in tumorE. swelling of breast42): Characteristics of lobular breast cancer include all of the following exceptA. often bilateralB. multicentricity within the same breastC. high incidence of estrogen receptor positivityD. 50% of all breast carcinomas43)A firm, sharply circumscribed neoplasm removed from the breast of a 25-year-old: woman is most likelyA. adenocarcinomaB. duct papillomaC. fibroadenomaD. fibrocystic disease

: 44)Breast diseases that tend to be bilateral includeA. fibrocystic diseaseB. lobular carcinoma-in-situC. both A and BD. Papillomata in major ductsE. plasma cell mastitis45)A disease typically caused by a traumatic blow to the breast isA. supernumerary nipplesB. fat necrosisC. plasma cell mastitisD. acute mastitisE. gynecomastia cell mastitis: 46)The mean age at diagnosis for carcinoma of the breast isA. 10B. 20C. 30D. 55E. 70?47)Which of the following breast diseases characteristically occurs during lactationA. supernumerary nipplesB. fat necrosis)C. mammary duct ectasia (plasma cell mastitisD. acute mastitisE. gynecomastia: 48)The mean age of diagnosis for fibroadenoma of the breast isA. 10B. 25

C. 35D. 55E. 70: 49)All of the following are correct in regard to invasive breast carcinoma exceptA. a leading cause of death from cancer in women in the Western worldB. carries a good prognosis if the mass is less than 1 cm in diameterC. has often spread to axillary lymph nodes at the time of detectionD. common between age 20 and 30E. more common in women whose mother and 4 sisters died of the same disease: 50)Fibroadenomas have all of the following common characteristics exceptA. occur in young womenB. contain an abundance of stromaC. are rubbery and discrete on palpationD. are associated with lymph node enlargementE. they are benign tumors?51)Which of the following forms of breast cancer has the best prognosisA. colloid carcinomaB. medullary carcinomaC. scirrhous carcinomaD. lobular carcinomaE. ductal carcinoma-in-situ?52)Which condition increases the risk of breast cancer at a later timeA. fibroadenomaB. duct papillomaC. sclerosing adenosisD. ductal hyperplasia with atypiaE. apocrine metaplasia

53)A 54-year-old woman presents with a left breast mass and enlargement of the left: axillary lymph nodes. The most likely histologic finding in the breast biopsy isA. necrosis of fat and chronic inflammationB. an abscess composed of PMN’sC. foreign body granulomataD. apocrine metaplasia of breast parenchymaE. invasive breast carcinoma?54)Which of the following is the most likely cause of a bleeding nippleA. duct papillomaB. fat necrosisC. galactoceleD. breast cancerE. fibroadenoma55)A 50-year-old female was found to have a 2 cm lump in the right breast on a routinephysical examination. The microscopic picture of an excisional biopsy showed all of the: following exceptA. pleomorphic, anaplastic epithelial cellsB. an abundance of mitosesC. foci of necrosisD. granulomatous inflammationE. sparse lymphocytic infiltrate, focally56)A 54-year-old woman presents with a left breast mass and enlargement of the left: axillary lymph nodes. Further work-up of this patient should includeA. intravenous pyelogramB. bone scan for evidence of metastatic diseaseC. lung biopsyD. study for antibodies to HLA antigensE. total white blood count

57)Irregular calcifications in mammograms are associated with the following breast:)disease(sA. in-situ ductal carcinomaB. invasive ductal carcinomaC. fat necrosisD. all of the above: 58)Invasive ductal carcinoma, Stage IV of the breast hasA. metastasized to distant organsB. estrogen receptorsC. an excellent prognosisD. decreased levels of serum alkaline phosphataseE. been confined to the breast: 59)Fibroadenoma is usuallyA. found in the elderly womanB. a premalignant tumorC. present as a breast lumpD. found during pregnancy60)Multiple irregular flecks of calcium on mammogram are likely to be present in which of: the following exceptA. fat necrosisB. ductal carcinoma-in-situC. ductal carcinomaD. abscessE. duct papilloma61)Each of the following pathologic entities are components of fibrocystic disease of the: breast exceptA. apocrine metaplasiaB. sclerosing adenosisC. plasma cell mastitis

D. ductal hyperplasiaE. cysts?62)A bleeding nipple may be a symptom of which breast diseaseA. duct papillomaB. fat necrosisC. galactoceleD. fibroadenoma: 63)Breast cancer may have the following characteristicsA. present as a firm, painless massB. be familialC. present with a bleeding nippleD. present as an axillary massE. all of the above: 64)Sclerosing adenosis of the breast isA. not seen in fibrocystic diseaseB. a component of fibroadenomasC. commonly seen in nursing mothersD. a hyperplastic epithelial lesionE. characterized by abundant mitoses: 65)All of the following findings on physical examination suggest breast cancer exceptA. hard mass in the breastB. painless, enlarged axillary lymph nodesC. bloody discharge from the nippleD. retraction of the nippleE. painful, enlarged axillary lymph nodes: 66)Bleeding from the nipple is associated with the following breast disease(s) exceptA. duct papilloma

B. Paget’s disease of the nippleC. plasma cell mastitisD. breast cancer67)A 30-year-old female was found to have a 2 cm lump in the right breast on a routinephysical examination. A mammogram showed minute foci of calcification in the area of?the lump. This would most likely correlate with which histologic featureA. granulomasB. necrosisC. high mitotic rateD. anaplasia: 68)The most common clinical presentation of a duct papilloma isA. a painful lumpB. a painless lumpC. a bloody nipple dischargeD. microcalcifications in mammogramsE. eczema and itching of the nipple and areola**AS4**

BREAST PATHOLOGY MCQS 1) :The most important factor in breast enlargement during pregnancy is A. stromal edema B. secretion of chorionic gonadotropin C. glandular hyperplasia D. proliferation of stroma E. increased secretion of oxytocin

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