material used during final exam preparation hope benefit for all *at own risk

1. SURGICAL BREAST
1. Breastmust know
a. Lump
b. Discharge
2. Breastembryo
a. Modifiedsweatgland
b. From 2 ics till 8/9th
rib
c. From lateral sternumtoant latissimusdorsi
3. Examinationmustmentionandcover
a. Breastproper
b. Areola
c. Nipple
d. Axilla
4. Breastdiseases classification
a. Congenital;absence/extranipple@breast
b. Trauma
c. Inflammation;mastitisorperiductularmastitis
d. Abcess;suboreolar,intramammary,retromammry
e. Metabolic; hormonal imbalance
5. Breastdisordermustknow/dx
a. Benign;fibroadenoma
b. Malignant;breastca
c. Hormonal;ANDI
6. Nipple retraction
a. Horizontal slit;benign
b. Circumferential slit;ca
HISTORY TAKING
1. Patientdetails;name,age
2. Presentation;discharge/lump
a. Lump hx
i. Onset
ii. Whennotice
iii. Duration
iv. Anysymptoms;paim
v. Rate of growth
3. Past history;radiation,abcess,breastca
4. Familyhistory;brca1/brca2
5. Menstrual history;age puberty/menarche/menopause/LMP
6. Social history;marital status,nulli/multipara,age of firstchild,breastfeed

2. EXAMINATION OF BREAST
1. Consent
2. Privacy
3. Chaperon
4. Exposure;necktill waist,bothbreast(modestyetc)
5. Position
a. Sitting
b. Semi-recumbent
c. Recumbent
d. Hand at side
e. Raise handabove head
f. Hand on waist,contractand relax
g. Pushingwall
h. Leaningforward
6. Must examine bothbreast
a. Must commentfirst/firstsentencesmustcome
i. Yada yada breast is NORMAL!
7. Must examine
a. Breastproper
b. Areola
c. Nipple
d. Axilla
8. Must see
a. Breast
b. Axilla
c. Supraclaviculararea
9. Lymphnode (5+2+1)
a. Axillagroup,5
i. Anterior
ii. Posterior
iii. Lateral
iv. Medial (central,axial)
b. Chest,2
i. Internal mammary
ii. Interpectoral
c. Supraclavicular,1

3. 10. Describe breastswelling
a. How many
b. Site
c. Shape
d. Size
e. Surface
f. Mobility
g. Pulsatility
h. Consistency
i. Firm
ii. Hard
iii. Soft
1. Fluctuation
2. Transillumination
3. Reducibility
4. Compressibility
i. Tenderness
11. Systemicexaminationmustdoandsee for what?
a. CVS
b. RS
i. Pleural effusion(clinical detectedsignof mets)
ii. Cannonball lesion(needcxr)
iii. Lymphangectasia(needcxr/ct@pet)
c. PER ABD
i. Ascites
ii. Livermets
iii. Krukenbergtumor
d. LOCOMOTOR/MSK
i. Gibbus
ii. Paraplegiasign
iii. FND
e. PR/PV
i. To detectkrukenbergtumor(female)
ii. To see metsto rectal sheath(male)