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  • Question 1 - Which of the following features is indicative of poor prognosis in a case...

    Correct

    • Which of the following features is indicative of poor prognosis in a case of breast carcinoma?

      Your Answer: Axillary lymph node metastases

      Explanation:

      Lymphatic spread indicates poor prognosis. Presence of family history is not a prognostic factor despite being linked to higher incidence. Aneuploidy is a poor prognostic factor. A breast tumour positive for oestrogen receptors is a good prognostic factor as it increases the responsiveness of the tumour to certain therapies. In-situ tumours carry the best prognosis.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      7.4
      Seconds

  • Question 2 - A 46-year old lady presents with chief complaints of a large mass in...

    Incorrect

    • A 46-year old lady presents with chief complaints of a large mass in the left breast. Histopathology of the mass revealed a stromal component with an epithelial component. What is the likely lesion?

      Your Answer: Medullary carcinoma of breast

      Correct Answer: Phyllodes tumour

      Explanation:

      Phyllodes tumours are large, quickly growing tumours which arise from the periductal stroma of the breast. These are fibroepithelial tumours and account for less than 1% of breast cancers. These tumours can be benign, borderline or malignant based on the histology. The tumour usually affects adult women, mostly between the age of 40 to 50 years. It can be confused with fibroadenoma, which however affects much younger patients.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      52.6
      Seconds

  • Question 3 - Bloody discharge from the nipple of a 40-year old woman with no obvious...

    Incorrect

    • Bloody discharge from the nipple of a 40-year old woman with no obvious lump or abnormality on mammography is suggestive of:

      Your Answer: Mastitis

      Correct Answer: Intraductal papilloma

      Explanation:

      A small benign tumour, namely intraductal papilloma is most common in women between 35-55 years of age. It is also the commonest cause of spontaneous discharge from a single duct. A lump below the nipple may be sometimes palpable. Ultrasound and ductography are useful investigations., along with cytology of discharge to assess the presence of malignant cells. Confirmation is by breast biopsy.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      10.6
      Seconds

  • Question 4 - Leakage from a silicone breast implant can lead to: ...

    Correct

    • Leakage from a silicone breast implant can lead to:

      Your Answer: Pain and contracture

      Explanation:

      Breast implants are mainly: saline-filled and silicone gel-filled. Complications include haematoma, fluid collections, infection at the surgical site, pain, wrinkling, asymmetric appearance, wound dehiscence and thinning of the breast tissue.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      5.4
      Seconds

  • Question 5 - Which of the following conditions of the breast is most often associated with...

    Correct

    • Which of the following conditions of the breast is most often associated with use of oral contraceptives?

      Your Answer: Cyst formation

      Explanation:

      Breast cysts are common and are smooth, firm, mobile lumps that can sometimes be tender. Cysts can also be bilateral and are known to recur in 10% of cases. They are more common in women in the third and fourth decades and most often disappear after menopause. Cysts are filled with fluid from the breast which occurs due to the normal menstrual cycle of a woman. The end of the menstrual cycle causes breast cells to swell. After the menses, the cells shrink and the released fluid disappears. However, in some cases this fluid forms a cyst. Incidence of cysts was also linked to use of oral contraceptives.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      10
      Seconds

  • Question 6 - A 38-year old woman presents to the clinic with a 2 cm eczema-like...

    Correct

    • A 38-year old woman presents to the clinic with a 2 cm eczema-like lesion on the areolar region of her left breast, for 5 months. Biopsy of the lesion showed large cells at the dermal-epidermal junction with positive staining for mucin. What is the likely diagnosis?

      Your Answer: Paget’s disease of the breast

      Explanation:

      Paget’s disease of the breast or nipple resembles eczema in appearance with an underlying carcinoma typically. The disease is usually unilateral and presents with inflammation, oozing and crusting along with a non-healing ulcer. Treatment is often delayed due to the innocuous appearance but can be fatal. It results due to spread of neoplastic cells from the ducts of the mammary gland to the epithelium.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      13.5
      Seconds

  • Question 7 - Cervical intraepithelial neoplasia on Pap smear of a 34-year old lady is most...

    Correct

    • Cervical intraepithelial neoplasia on Pap smear of a 34-year old lady is most likely associated with which of the following?

      Your Answer: Human papillomavirus infection

      Explanation:

      CIN (Cervical intraepithelial neoplasia) is considered a precursor of cervical cancer and is likely caused due to infection with human papillomavirus (HPV) types 16, 18, 31, 33, 35 or 39. The risk factors for cervical cancer include multiple sex partners, young age at the time of first intercourse, intercourse with men whose previous partners had cervical cancer. Also, smoking and immunodeficient states are considered contributory. CIN is graded as mild (grade I), moderate (grade II) and severe dysplasia or carcinoma in situ (grade III). CIN III rarely regresses spontaneously and can lead to invasive carcinoma by invading the basement membrane. Squamous cell carcinomas are the commonest cervical cancer seen in 80-85% of all cases. Others are commonly adenocarcinomas. Cervical cancer can spread by direct extension, lymphatic spread to pelvic and para-aortic nodes or by hematogenous route.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      4.1
      Seconds

  • Question 8 - Endometrial hyperplasia is most likely to be associated with which of the following...

    Correct

    • Endometrial hyperplasia is most likely to be associated with which of the following conditions?

      Your Answer: Fibrothecoma

      Explanation:

      A benign tumour arising from the ovarian stroma, fibrothecoma are bilateral in 10% cases. The thecoma component of the tumour can produce oestrogen leading to endometrial hyperplasia. The thecoma is rich in lipid content and is responsible for the yellowish appearance of the tumour. Meig’s syndrome is the presence of fibrothecoma with a right-sided hydrothorax.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      6.6
      Seconds

  • Question 9 - A 24-year old, lactating mother presents to the clinic with a tender, 1.5cm...

    Correct

    • A 24-year old, lactating mother presents to the clinic with a tender, 1.5cm mass just below the right nipple, which shows multiple fissures. What finding is likely associated with her condition?

      Your Answer: Staphylococcus aureus infection

      Explanation:

      Breast abscess occur commonly in lactating mothers in the postpartum period due to cracking of the nipple. It is commonly caused due to Staphylococcus aureus infection. Fat necrosis usually results from trauma wherein an ill-defined mass is formed. Ductal carcinomas are malignant masses which are not tender usually, and rare in the young age group. Plasma cell mastitis affect women in an older age group. Sclerosing adenosis is a type of fibrocystic disease which can lead to a tender, cystic mass but no fissuring or cracks are seen in the nipple. Fibroadenoma and lipomas are non-tender, well-defined masses.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      12.5
      Seconds

  • Question 10 - A 28-year old lady comes to the surgical clinic with a recently detected...

    Correct

    • A 28-year old lady comes to the surgical clinic with a recently detected lump in her right breast. On examination, the lump is found to be 1cm, rubbery, mobile with no palpable axillary nodes. Mammography reveals no microcalcifications and the opposite breast appears normal. What is the likely diagnosis?

      Your Answer: Fibroadenoma

      Explanation:

      A benign breast tumour, fibroadenoma is common below the age of 30 years and occurs due to oestrogenic excess. It is characterised by proliferation of both glandular and stromal elements. Fibroadenomas are usually solitary and are mobile, not fixed to surrounding structures. The tumour is elastic, nodular and encapsulated with a grey-white cut surface. The two main histological types include intracanalicular and pericanalicular types, with both types often present in the same tumour. In the intracanalicular type, the stromal proliferation component predominates causing compression of ducts making them appear slit-like. In pericanalicular type, the fibrous stroma dominates around the ductal spaces so that they remain oval on cross section.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      42.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Pathology (8/10) 80%
Women's Health (8/10) 80%
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