18 Neck

Question 1

A supraclavicular stab wound is in which neck zone

Answer 1

Zone I

Question 2

T/F: Enlargement of the preauricular LN is indicative of parotid pathology

Answer 2

False, these nodes can enlarge from inflammation or mets from scalp

Question 3

What is the m/c H&N manifestation of neuroblastoma

Answer 3

Cervical metastatic dz

Question 4

What is the m/c presentation of parapharyngeal space tumor

Answer 4

Medial displacement of lateral OP wall or as a palpable mass beneath the angle of the mandible

Question 5

What is the classic PE finding of carotid body tumor

Answer 5

Freely moveable in lateral direction but fixed cephalic-caudal

Question 6

How can one differentiate a vagal paraganglioma from carotid body tumor

Answer 6

Vagal: displace ICA and ECA anteromedially

CB: displace ICA posterior and ECA anterior

Question 7

What is the risk of performing an FNA on scrofula

Answer 7

May lead to chronically draining cutaneous fistula

Question 8

What percent of thyroid nodules are benign on FNA

Answer 8

70%

Question 9

What is incidence of nondiagnostic or suspicious result on thyroid nodule FNA

Answer 9

25%

Question 10

What percent of thyroid nodules are malignant when FNA is suspicious

Answer 10

For papillary and Hurthle, risk of malig is 57%

For follicular, risk is 20-25%

Question 11

What is incidence of false + and - with FNA of thyroid nodules

Answer 11

4%; 4%

Question 12

T/F: FNA should be performed on a 6 mm nodule if u/s showed microcalcifications

Answer 12

True

Question 13

What factors significantly inc risk of sampling error from FNA

Answer 13

Very small (<1 cm)
Very large (>4 cm)
hemorrhagic nodules
Multinodular glands

Question 14

Most false + thyroid FNAs are due to what dz

Answer 14

Hashimotos

Question 15

Which thyroid tumors can’t be dx as malig w/ FNA

Answer 15

Follicular and Hurthle cell

Question 16

What percent of nodules with follicular or Hurthle cells on FNA are malig

Answer 16

10-20%

Question 17

What illness is characterized by a staccato cough

Answer 17

Chlamydial PNA

Question 18

What dz’s may p/w hemoptysis in kids

Answer 18

bronchiectasis, CF, foreign body, pulmonary hemosiderosis, TB

Question 19

What illness is characterized by a seal-like barking cough

Answer 19

croup

Question 20

What kind of stridor in tracheomalacia

Answer 20

expiratory

Question 21

What test has the highest yield for dx of vascular rings

Answer 21

DL/B

Question 22

What is the typical endoscopic appearance of inominate artery compression

Answer 22

Pulsatile compression of anterior tracheal wall in distal trachea

Question 23

What is the “Waterson sign?”

Answer 23

Obliteration of the right radial pulse by compressing the anterior tracheal indentation with tip of bronchoscope

Question 24

What is test of choice in evaluation of caustic injury

Answer 24

endoscopy

Question 25

When is ideal to perform endoscopy after caustic ingestion

Answer 25

24-48 hrs

Question 26

What info does esophageal manometry provide

Answer 26

UES responsiveness and pharyngeal peristalsis

Question 27

What is the sensitivity of the 24 hr pH probe for GERD

Answer 27

92-94%

Question 28

What is the Euler-Byrne formula

Answer 28

“X + 4Y, where X = number of episodes the pH is <4 and Y = number of episodes the pH is <4 for >5 minutes; a score of 50+ is clinically significant for GERD.

Question 29

What is the best test to distinguish obstructive from restrictive lung dz

Answer 29

Pulmonary function test

Question 30

PFT results for COPD

Answer 30

Both FEV1 and FEV1/FVC would be decreased and RV and TLC would be increased.

Question 31

PFT results for 44 yo F with PNA

Answer 31

Both FEV1 and FVC would be decreased; FEV1/FVC would be nl