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A - MSRA ENT [6] > [2] Neck Lumps > Flashcards

[2] Neck Lumps Flashcards

1
Q

What are most neck lumps caused by?

A

A benign cause

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2
Q

Why is thorough assessment of neck lumps necessary?

A

Because it could be due to more serious disease

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3
Q

What is the most common cause of neck lumps?

A

Reactive lymph nodes

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4
Q

What are the most common causes of reactive lymph nodes?

A
  • Bacterial
  • Viral
  • Parasitic
  • Non-infective causes
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5
Q

What are the common bacterial causes of reactive neck lymph nodes?

A
  • Beta haemolytic strep
  • Staph aureus
  • Tuberculosis
  • Secondary syphilis
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6
Q

What are the common viral causes of reactive neck lymph nodes?

A
  • URTI viruses
  • EBV
  • CMV
  • HIV
  • HSV
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7
Q

What are the common parasitic causes of neck reactive lymph nodes?

A
  • Head lice
  • Fungal infections
  • Toxoplasmosis
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8
Q

What are the common non-infective causes of reactive neck lymph nodes?

A
  • Sarcoidosis

- Connective tissue disease

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9
Q

What are some rare types of neck lumps?

A
  • Malignant lymph nodes
  • Infections of the skin
  • Lipomas and other benign tumours
  • Thyroid swellings
  • Salivary gland problems
  • Congenital swellings
  • Developmental abnormalities
  • Carotid aneurysm or tumour
  • Malignant tumours
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10
Q

What can cause malignant cervical lymph nodes?

A
  • Leukaemia
  • Lymphoma
  • Metastases
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11
Q

What infections of the skin can cause neck lumps?

A
  • Abscess

- Infected sebaceous cyst

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12
Q

What benign tumours can cause neck lumps?

A
  • Lipomas
  • Fibromas
  • Chondromas
  • Neuromas
  • Vascular tumours
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13
Q

What types of thyroid swellings can cause neck lumps?

A
  • Diffuse enlargement
  • Nodules
  • Cancers
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14
Q

What salivary gland problems can cause neck lumps?

A
  • Tumours
  • Blocked ducts
  • Infection and inflammation
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15
Q

What congenital swellings can cause neck lumps?

A
  • Thyroglossal cyst
  • Dermoid cyst
  • Cystic hygrometer
  • Lymphangioma
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16
Q

What developmental problems can cause neck lumps?

A
  • Branchial cyst
  • Laryngocoele
  • Pharyngeal pouch
  • Cervical rib
17
Q

What malignant tumours can cause neck lumps?

A
  • Sarcoma
  • Chondrosarcoma
  • Skin malignancy
18
Q

What factors should be considered when assessing history of a neck lump?

A
  • Age of patient
  • Onset
  • Consistency and mobility
  • Location
  • Associated symptoms
19
Q

What type of neck lumps are more common in young people?

A

Inflammatory (more common than malignant)

20
Q

What types of neck lumps are common in children and young people?

A

Congenital and developmental causes

21
Q

What is the typical natural history of inflammatory neck lumps?

A
  • Sudden onset

- Resolution in 2-6 weeks

22
Q

What does progressive enlargement over short period of time suggest of a neck lump?

A

More likely to be malignant

23
Q

What features of history suggest salivary gland problem as a cause of neck lump?

A

Transient with association with eating

24
Q

What is a hard neck lump more likely to be?

A

Malignancy

25
Q

How do congenital masses usually feel?

A

Smooth and mobile

26
Q

How can thyroid gland swellings and thyroglossal cysts be identified on examination?

A

They move when swallowing (thyroglossal cysts move when tongue moved out)

27
Q

What does a tender neck lump suggest?

A

Infection

28
Q

What are midline lumps more likely to be?

A

Thyroid in origin

29
Q

What a posterior triangle lumps most commonly?

A

Lymph nodes

30
Q

What are bilateral swellings across the mandibular angles likely to be?

A

Parotid infection

31
Q

What can submandibular swellings be related to?

A

The submandibular gland

32
Q

What can a lump in the left supraclavicular ross indicate?

A

Infraclavicular metastatic malignancy

33
Q

What are some red flag symptoms of haematological malignancies?

A
  • Night sweats
  • Weight loss
  • Pruritis
  • Fever
  • Bruising
  • Breathlessness
  • Fatigue
34
Q

What investigations can be used to differentiate neck lumps?

A
  • FBC and ESR
  • TFT
  • Viral serology
  • Throat swab
  • CXR
  • USS
  • Radionucleotide scanning
  • CT or MRI
35
Q

Where should neck lumps be referred?

A

ENT but also dermatology, oral surgeon or chest physician depending on suspected cause

36
Q

When should an urgent 2WW referral be made for patients with a neck lump?

A
  • Lost weight
  • Hoarseness, dysphagia or dyspnoea for >3 weeks
  • Symptoms of haematological malignancy
  • Unexplained large lymph node
  • Suspicious clinical features
  • Diagnosis unclear

A - MSRA ENT [6] (22 decks)

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