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  • Question 1 - 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
      11.1
      Seconds
  • Question 2 - A young female in the 15th week of pregnancy presented to the emergency...

    Correct

    • A young female in the 15th week of pregnancy presented to the emergency department with the passage of grape-like masses per vagina. Dilatation and curettage was done and microscopy revealed large avascular villi with trophoblastic proliferation. Which one of the following investigations is best recommended for her follow-up?

      Your Answer: Serum β-hCG

      Explanation:

      Trophoblast is the layer of cells surrounding the blastocyst and that later develops into the chorion and amnion. Gestational trophoblastic disease is a tumour arising from this trophoblast. It can occur during or after either an intrauterine or ectopic pregnancy. If it occurs in a pregnant woman, it usually leads to spontaneous abortion, eclampsia or fetal death. It can be either malignant or benign.

      In suspected cases, investigations include measurement of serum beta subunit of human chorionic gonadotrophin (β-hCG) and pelvic ultrasound. Confirmatory test is a biopsy. Post-removal, the disease is classified clinically to assess further treatment. To assess the presence of metastases, further work-up includes computed tomography of the brain, chest, abdomen and pelvis. Chemotherapy is usually needed for persistent disease. If at least three consecutive, weekly serum β-hCG measurements are normal, treatment is considered successful. Follow-up is also done by measuring β-hCG.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      21.3
      Seconds
  • Question 3 - 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
      16.9
      Seconds
  • Question 4 - What is the most likely cause of bilateral gynaecomastia in a 55-year old...

    Correct

    • What is the most likely cause of bilateral gynaecomastia in a 55-year old male?

      Your Answer: Hepatic failure

      Explanation:

      Hypertrophy of breast tissue in males is known as gynaecomastia. It is normally due to proliferation of stroma and not of mammary ducts. Physiological gynaecomastia can occur during puberty and is often transient, bilateral, symmetrical and possibly tender. Gynaecomastia can occur during old age too, but is usually unilateral. Other causes include hepatic or renal failure, endocrinological disorders, drugs (anabolic steroids, antineoplastic drugs, calcium channel blockers, cimetidine, digitalis, oestrogens, isoniazid, ketoconazole, methadone, metronidazole, reserpine, spironolactone, theophylline), and marijuana. It should not be confused with malignancy which is often hard, asymmetric and fixed to the dermis or fascia. Treatment if indicated, includes withdrawal of the causative factor or treatment of the underlying disorder.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      22.3
      Seconds
  • Question 5 - 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
      14.1
      Seconds
  • Question 6 - Which of the following features is indicative of poor prognosis in a case...

    Incorrect

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

      Your Answer: Absence of vascular invasion

      Correct 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
      22.6
      Seconds
  • Question 7 - The likely cause of a tender and swollen breast in a lactating mother...

    Correct

    • The likely cause of a tender and swollen breast in a lactating mother is:

      Your Answer: Acute mastitis

      Explanation:

      Acute mastitis results due to bacterial infection of the breast and results in signs of inflammation. It commonly occurs 2-3 weeks postpartum and common causative microorganisms are Staphylococcus aureus, Streptococcus species, and Escherichia coli. Complications like an abscess can be avoided by prompt treatment, which includes antibiotics and rest along with continued lactation.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      6.6
      Seconds
  • Question 8 - A 38-year old lady presented to the hospital with abnormal passing of blood...

    Correct

    • A 38-year old lady presented to the hospital with abnormal passing of blood per vagina. On examination, she was found to have an endocervical polypoidal mass. On enquiry, she gave history of oral contraceptive usage for 3 years. What finding is expected on the histopathology report of biopsy of the mass?

      Your Answer: Microglandular hyperplasia

      Explanation:

      Endocervical polyps or microglandular hyperplasia are benign growths occurring in the endocervical canal, in about 2-5% women and occur secondary to use of oral contraceptives. They are usually < 1cm in size, friable and reddish-pink. Usually asymptomatic, they can cause bleeding or become infected, leading to leucorrhoea (purulent vaginal discharge). They are usually benign but need to be differentiated from adenocarcinomas by histology.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      30.7
      Seconds
  • Question 9 - A 18-year old girl presents to her doctor with an excessively enlarged left...

    Correct

    • A 18-year old girl presents to her doctor with an excessively enlarged left breast as compared to the right breast since puberty. The most likely cause for this is:

      Your Answer: Virginal breast hypertrophy

      Explanation:

      Virginal breast hypertrophy’ is the term assigned to excessive growth of breasts during puberty and is a common phenomenon. It is also known as ‘juvenile macromastia’ or ‘ juvenile gigantomastia’. The breast hypertrophy often starts with menarche and occasionally occurs in growth spurts. These spurts can cause physical discomfort, red and itchy skin or pain in the breasts. The breasts can also grow continuously over several years and lead to overdevelopment of a normal breast. Nipples also undergo enlargement along with the breasts.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      16.8
      Seconds
  • Question 10 - A 45-year old lady underwent biopsy of a soft, fleshy mass involving her...

    Correct

    • A 45-year old lady underwent biopsy of a soft, fleshy mass involving her left breast. The biopsy showed lymphoid stroma with minimal fibrosis, surrounding sheets of large vesicular cells with frequent mitoses. Which condition is she most likely suffering from?

      Your Answer: Medullary carcinoma of breast

      Explanation:

      Medullary carcinoma is a malignant tumour of the breast with well-defined boundaries and accounts for 5% of all breast cancers. Other special features include a larger size of the neoplastic cells and presence of lymphoid cells at tumour edge. Differential diagnosis includes invasive ductal carcinoma. Prognosis is usually good.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      21.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Pathology (9/10) 90%
Women's Health (9/10) 90%
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