Clinicals:
General 1: 80 large breast ca, very comorbid, Hx and O/E. Discussion about primary endocrine therapy. Examine legs – chronic venous changes, what are they? If not as comorbid, what would you do?
General 2: Thyroid nodule. Hx and O/E. Counselling re surgery. (isthmus so total thyroidectomy)
General 3: Achalasia. Hx and O/E. Ba swallow – bird’s beak deformity. OGD and manometry.
Breast 1: 6mm spiculated lesion on mammo (screening), G cup breast. Contralteral DXT changes – asked what they are
Breast 2: BBR post op (not for cancer): what are the scars, what’s been done. Possible complications.
Breast 3: DCIS in two areas (shown mammo), extensive microcalc, quite far apart. Hx and O/E. Management options. Reconstruction options. Contraindications to LD.
General tips:
Don’t forget PMHx
Vivas:
Inflammatory breast ca
Pregnancy-associated breast ca
FHx and BRCA
Paget’s and bloody nipple discharge
Popliteal fossa gunshot injury
Femoral hernia
Anastomotic leak