American Board of Internal Medicine (ABIM) Certification Practice Exam

What is required for any bloody fluid obtained from breast cyst aspiration?

1. Ultrasound examination

2. Cytologic examination

3. Immediate surgical intervention

4. Pathological review

The correct answer is: Cytologic examination

For any bloody fluid obtained from breast cyst aspiration, a cytologic examination is required to evaluate for potential malignancy. When fluid is aspirated from a breast cyst and it is bloody, there is a possibility that the blood may indicate underlying pathology, such as the presence of carcinoma. A cytologic examination allows for the assessment of the cellular characteristics of the aspirated fluid, helping to determine if there are abnormal cells that might suggest a malignancy. While ultrasound examination helps guide the aspiration and assess the characteristics of the cyst, it does not analyze the fluid itself. Immediate surgical intervention may not be necessary unless there are concerning findings that warrant it. Similarly, a pathological review typically refers to tissue samples rather than fluid aspirations; thus, while it could be relevant in some cases, it is not the immediate requirement for blood-stained fluid obtained from a cyst. Cytologic analysis is crucial for identifying any cellular changes that may necessitate further investigation or intervention.