Breast cancer: Clinical (To be retired)

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Breast cancer: Clinical (To be retired)

Medicine and surgery

Allergy and immunology

Antihistamines for allergies

Glucocorticoids

Cardiology, cardiac surgery and vascular surgery

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Hypertension: Clinical (To be retired)

Hypercholesterolemia: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Thiazide and thiazide-like diuretics

Calcium channel blockers

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Dermatology and plastic surgery

Hypersensitivity skin reactions: Clinical (To be retired)

Eczematous rashes: Clinical (To be retired)

Papulosquamous skin disorders: Clinical (To be retired)

Alopecia: Clinical (To be retired)

Hypopigmentation skin disorders: Clinical (To be retired)

Benign hyperpigmented skin lesions: Clinical (To be retired)

Skin cancer: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Dizziness and vertigo: Clinical (To be retired)

Hyperthyroidism medications

Hypothyroidism medications

Insulins

Hypoglycemics: Insulin secretagogues

Miscellaneous hypoglycemics

Gastroenterology and general surgery

Gastroesophageal reflux disease (GERD): Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Diarrhea: Clinical (To be retired)

Malabsorption: Clinical (To be retired)

Colorectal cancer: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Anal conditions: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Breast cancer: Clinical (To be retired)

Laxatives and cathartics

Antidiarrheals

Acid reducing medications

Hematology and oncology

Anemia: Clinical (To be retired)

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications

Infectious diseases

Pneumonia: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications

Azoles

Echinocandins

Miscellaneous antifungal medications

Anti-mite and louse medications

Nephrology and urology

Chronic kidney disease: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Urinary incontinence: Pathology review

ACE inhibitors, ARBs and direct renin inhibitors

PDE5 inhibitors

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Headaches: Clinical (To be retired)

Migraine medications

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Lung cancer: Clinical (To be retired)

Antihistamines for allergies

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Rheumatoid arthritis: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs

Glucocorticoids

Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications

Non-biologic disease modifying anti-rheumatic drugs (DMARDs)

Osteoporosis medications

Assessments

Breast cancer: Clinical (To be retired)

USMLE® Step 2 questions

0 / 34 complete

Questions

USMLE® Step 2 style questions USMLE

of complete

A 50-year-old woman comes to the office due to a breast lump she noticed on self-examination several days ago. Medical history is notable for hypertension controlled with hydrochlorothiazide. She does not smoke or use excessive alcohol. Family history is negative for cancer. Vitals are within normal limits. On physical examination, a non-tender, fixed mass in the right upper quadrant of the right breast is palpated, and mild skin dimpling is noted. There is no axillary lymphadenopathy, and there are no nipple changes. Mammogram reveals a calcified mass with spiculated margins. Core-needle biopsy is obtained and confirms the diagnosis of early staged infiltrating ductal carcinoma clinical stage (cTNM) T1cN0M0. Immunohistochemistry for receptor status is negative for estrogen and progesterone receptors but positive for HER2 amplification. Prior to initiating the appropriate chemotherapeutic medication, which of the following should be done?  

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Antonella Melani, MD

Sam Gillespie, BSc

Tanner Marshall, MS

Breast cancer, or breast carcinoma, is an uncontrolled growth of epithelial cells within the breast.

It’s the most common cancer in women, but can rarely affect men as well.

Now, estrogen and progesterone stimulate breast cells to grow and divide, and exposure to them over long periods of time increases the risk of breast cancer.

More menstrual cycles over a lifetime means a higher cumulative exposure to these hormones. That’s why factors that increase the number of menstrual cycles increases the risk of breast cancer.

That includes things like early menarche, or a first menstrual bleeding before 11 years of age, and late menopause, after 54 years of age.

On the flip side, some factors that are associated with fewer lifetime menstrual cycles - like pregnancy and a longer time breastfeeding - decrease the risk of breast cancer.

Similarly, hormone replacement therapy used to treat menopause symptoms, also increases that risk.

Another risk factor is exposure to ionizing radiation, like from chest X-rays and CT scans or previous radiation therapy for other cancers located in the chest.

Breast cancer has been linked to mutations in tumor suppressor genes, like BRCA1, BRCA2, and TP53, which normally prevent uncontrolled cell division.

Some breast cancers have mutations in the ERBB2 gene which causes an increase in human epidermal growth factor receptor 2, or HER2, which promotes cell division.

Finally, some breast cancer cells have estrogen or ER receptors and progesterone or PR receptors, which allow them to divide faster in the presence of these hormones.

Breast cancer is the second leading cause of cancer deaths in women after lung cancer, and this is largely due to the fact that breast cancers often don’t cause pain or discomfort until they’ve metastasized.

Elsevier

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