HTHSCI 1DT3 Lecture Notes - Lecture 15: Chronic Liver Disease, Inverted Nipple, Danazol
26 Dec 2020
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Document Summary
Amastia: complete absence of breast and nipple. Can occur anywhere along the milk line. Occurs in 30% of boys at puberty. Chronic liver disease: hypogonadism + e2 metabolism. Surgical duct excision if mass present or discharge troublesome. Ca @ 1%/yr (10x risk) in ipsilateral breast. Risk ca risk (x10) in both breasts. Extensive or multifocal mastectomy + reconstruction + snb. Bilateral prophylactic mastectomy or close watching c mammographic screening. Chronic limb ischaemia: presentation and classification 86. Chronic limb ischaemia: investigation and management 87. 5% of males >50yrs have intermittent claudication. Persistent rest pain requiring analgesia for 2wks. Typically asymptomatic until 50% stenosis (vasculitis and fibromuscular dysplasia are v. rare causes) Atherosclerosis summary: endothelial injury: haemodynamic, htn, lipids, chronic inflammation. Lymphocyte and smc recruitment: sm proliferation: conversion of fatty streak to atherosclerotic plaque. Atherosclerosis = arterial hardening specifically due to atheroma. Necrotic centre: cell debris, cholesterol, ca, foam cells. Cramping pain after walking a fixed distance.
