404 Obstetrics and Gynecology Board Review •••
❍ Is there an increased risk of carcinoma in a patient with multiple intraductal papillomas?
Yes. They may be also associated with concurrent atypical ductal hyperplasia (ADH), ductal carcinoma, in situ
(DCIS), or invasive carcinoma.
❍ What condition most commonly causes a greenish nipple discharge?
Ductal ectasia
❍ What is ductal ectasia?
Periductal mastitis, which is characterized by duct dilatation, fibrosis, and lymphoplasmacytic inflammation.
❍ What is seen on ultrasonography with ductal ectasia?
Dilated ducts with thickened walls in the central breast.
❍ Nonpuerperal mastitis is most commonly seen when?
After trauma. Other causes include foreign body and malignancy.
❍ What are contraindications to breastfeeding?
Those who take street drug or alcohol abuse, infant with galactosemia, HIV positive, active, untreated tuberculosis,
breast cancer treatment or radiation therapy, human T-cell lymphotropic virus type I or type II, and use of certain
medications, such as antiretrovirals or cancer chemotherapy agents.
❍ Does hepatitis B infection preclude breastfeeding?
No. With appropriate immunoprophylaxis, including hepatitis B immune globulin and vaccine, breastfeeding
poses no additional risk for the transmission of the virus.
❍ What are the complications of lactation?
Mastitis, breast abscess, nipple excoriation, tenderness, and galactocele formation.
❍ What condition may result from severe intrapartum or early postpartum hemorrhage?
Sheehan syndrome (pituitary failure).
❍ What are the signs and symptoms of Sheehan syndrome?
Failure of lactation, amenorrhea, breast atrophy, hypothyroidism, and adrenal cortical insufficiency.
❍ Which vitamin is absent in breast milk?
Vitamin K.
❍ What is galactorrhea?
The pathologic secretion of milky fluid without associated pregnancy and lactation. It is frequently associated with
amenorrhea and may be caused by a host of endocrine disorders or be a consequence of a medication.