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ENT > Adult Neck masses > Flashcards

Adult Neck masses Flashcards

1
Q

WHat type of cancer is found in the superior jugular chain?

A

Mets from nasopharynx

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2
Q

WHat type of cancer is found in the lower jugular chain?

A

MEts from thyroid, piriform sinus, upper esophagus

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3
Q

WHat type of cancer is found in the Mid jugular chain?

A

Mets from oral cavity, pharynx or larynx (Waldeyer’s tonsillar ring)

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4
Q

WHat type of cancer is found in the Posterior Triangle?

A

Mets from nasopharynx, post scalp, ear, temporal bone, or skull base

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5
Q

WHat type of cancer is found in the submandibular triangle?

A

Mets from anterior 2/3 of tongue, floor of mouth, gums, mucosa of cheek

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6
Q

WHat type of cancer is found in the submental Triangle?

A

Cancer of Lip rarely involved early

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7
Q

What are risk facors for Head and NEck cancer?

A 
Chronic Sun exposure
Tobacco and alcohol
Poor dentition
Industrial/envt exposure
FHx
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8
Q

What are the Sx of H/N Cancer?

A 
Non-healing ulcer of mouth
Persistent sore throat
Dysphagia
Change in voice
Recent weight change
Ear pain w/ normal ear exam
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9
Q

WHat diagnostic tests are done on head and neck cancers?

A 
Fine needle aspiration
Computer Tomography
MRI
US
Radionucleotide scanning
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10
Q

What are the indications for fine needle biopsy?

A

Any neck mass that isn’t an obvious abcess
Persistence after Abtx
Progressive growth, supraclavicular
Anx sx of lymphoma

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11
Q

What are the contraindications of Fine needle biopsy?

A

Near carotid artery?

US Guidance?

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12
Q

What are good tips for FNAB?

A

Proper Collection
Min of 4 passes
Skilled cytopathologist essential
On-site review best

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13
Q

What are the traits of Computed Tomography in H/N Cancers?

A 
Distinguish cystic from solid
Ext of lesion
Vascularity
Detection of unkn 1^ tumor
Pathologic Node
Avoid contrast in THyroid lesions
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14
Q

What are the considerations of MRI in H/N Cancers?

A

Similar info as CT
Better for upper neck and skull base
Vasc delineation w/ infusion

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15
Q

What are the considerations of US in H/N Cancers?

A

Less important now w/ FNAB
Solid vs cystic
Congenital cysts from solid nodes/tumors
Non-invasive

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16
Q

What are the considerations of Radionucleotide Scanning in H/N Cancers?

A

Salivary and thyroid masses
Loc-Gland vs Extra-Gland
Funct info

17
Q

What is the Workup procedure for Nodal mass workup in the adult?

A

Any solid asymmetric Mass
Ips otalgia w/ normal otoscopy => attn to tonsil, tongue base, supraglottis and hypopharynx
Uni serous otitis => Examine nasopharynx

18
Q

When is Open excisional Biopsy done?

A 
Complete Workup (-)
Complete neck dissection?
Frozen section? 
-Inflamm or Gran- Cuture
-Lymphoma or Aden CA- Close wound
19
Q

What is the most common neoplastic condition in children?

A

Thyroid mass

20
Q

What is the Dx test used for Thyroid Mass?

A

FNAB

21
Q

What are the Sx of Lymphoma?

A

Lateral neck mass
Fever
Hepatosplenomegaly
Diffuse adenopathy

22
Q

Where is a mass usually found in Hodgkin’s lymphoma?

A

Neck mass

23
Q

What are the traits of Benign vs Malignant Salivary Gand tumors?

A

Enl mass ant/inf to ear or at the mandibular angle
Ben: Asympt except for mass
Mal: Rapid Growth, skin fixation, CN palsy

24
Q

What are the traits of Carotid Body Tumors?

A

Rare in children
Pulsitile compressible mass
Mobile med/lat, not sup/inf

25
Q

What is the Tx of Carotid Body Tumor?

A

Irrigation or close observation in the elderly

Surgical resection for small tumors in young Pts

26
Q

What are the traits of neurogenic tumors?

A

Neural crest derivatves
Schwannoma, neurofibroma
Inc incidence in NF synd

27
Q

What are Sx of Schwannoma?

A

Medial Tonsillar Displacement
Hoarseness
Horner’s Syndrome

28
Q

What is the Tx of Branchial Cleft Cysts?

A

Initial control if infection

Surgical Excision w/ tract

29
Q

What is the Tx of Thyroglossal Duct Cysts?

A

same as TGDC

30
Q

What is the diff in Tx betwenn Lymphangioma and Hemangioma?

A

Lym: Excision for accessible recurrence common
Hem: Excision if rapid growth or if fails medical Thx

ENT (12 decks)

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