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Clinical medicine HEENT > Final Part > Flashcards

Final Part Flashcards

1
Q

glands involved in sialothiasis

A

submandibular, sublingual, parotid
-submandibular is the most common bc the gland is long and the flow of the saliva

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2
Q

sialolithiasis presentation

A

pain and swelling but can be painless
-pain with eating
-stone can be seen at the opening of the affected gland and can also be palpates along the course of the duct

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3
Q

when to be concerned about malignancy for sialolithiasis

A

-solid lesion on imaging
-cystic/ soft on palpation would be benign

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4
Q

acute bacterial sialadenitis

A

suppurative sialadenitis that is most common at parrots gland and by s.aur

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5
Q

acute bacterial sialadenitis s+s

A

-pain and swelling with meals
-tenderness and erythema of duct opening
*pus

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6
Q

how ever will we treat acute bacterial sialadenitis

A

incision and antibiotics

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7
Q

salivary gland tumor locations

A

parotid gland MC

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8
Q

pleomorphic adenoma

A

benign salivary tumor

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9
Q

mucoepidermoid carcinoma and adenoid cystic carcinoma

A

malignant salivary gland tumor

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10
Q

viruses that give u risk of salivary gland tumor oh no

A

EBV, HIV, HPV

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11
Q

criteria for abnormal lymph node

A

bigger than 1.5 cm with decreased motility with a firm rubber feel
-can be parotid or thyroid gland tumor

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12
Q

age above 40

A

more likely that a neck mass would be malignant not inflammatory

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13
Q

what if you have a mass chilling for years not changing

A

benign, watch for the fast changing ones

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14
Q

what if the mass fluctuates a lot

A

congenital that fluctuates with infections

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15
Q

ddx for a nodal neck mass in adults

A

nodal metastasis from HPV thAT is causing oropharyngeal squamous cell carcinoma

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16
Q

what causes pain from neck mass

A

the growth of the mass or neural invasion

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17
Q

night sweats and fever

A

lymphoma

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18
Q

spiking fever alone

A

acute infection

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19
Q

other causes of neck masses

A

hematoma, av fistula, pseudo aneurysm

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20
Q

what to look for when pt has a neck lump

A

skin lesions that could indicate squamous cell carcinoma/ malignant melanoma orrr kitty cat scratch disease

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21
Q

red flag of a neck lump

A

facial nerve weakness bc that could be a parotid gland tumor
-this is an aggressive cancer
-check forehead, cheek and chin trigeminal nerves

22
Q

characteristics of an infected lump

A

warm, tender, erythematous

23
Q

what is the mass moves from side to side NOT arriba y abajo

A

it has invaded the carotid sheath
-this can be carotid body tumor or vagal schwannoma

24
Q

what is the lump moves with swallowing

A

thyroglossal duct cyst or thyroid tumor

25
Q

where will lateral neck masses be and what are they

A

on the sternocleidomastoid muscle
-could be cyst, sinus or fistula
-can be brachial anomaly (congenital)
-they are soft, painless and slow to grow

26
Q

MC causes of infectious neck masses

A

-mumps, toxoplasmosis, coccidiodymcosis

27
Q

Lyme s+S

A

facial paralysis, synesthesias, dyspepsia cranial neuropathy
-cervial lymphadenopathy, headache, pain

28
Q

kitty cat scratch pathogen

A

rochalimaea henselae (gram neg rod)

29
Q

cat presentation

A

local papule, pustule, vesicle on top scratch

30
Q

cat tests

A

skin test with antigen (hanger-rose), anti-bartonella henselae ism titler, biopsy for pleomorphic intracellular rods and warthog starry silver impregnation stain

31
Q

cat complications and tx

A

-rare: near, liver, spleen, bone, skin
-spontaneously resolves

32
Q

thyroglossal duct cyst cause

A

due to the remnants of the epithelial thyroglossal tract bc it did not close/ develop in feet
-at midline of neck @ thyroid

33
Q

types of congenital masses

A

-thyroglossal cyst, brachial cleft or fistula, dermoid cyst, lymphangioma, congenital toricollis (rare), teratoma (rare), thymic mass (rare)

34
Q

how to see thyroglossal duct cyst

A

-mri or ct or us
-dye the track with fitulography

35
Q

lymphangioma

A

malformation of the lymph system that needs surgery, sclerotherapy, laser therapy or retreofrequency ablation

36
Q

toricollis

A

postural neck deformity that causes lateral neck flexion and neck rotation, the chin is pointed to the other side

37
Q

que is the result of thymic tissue implantation during the embryologic descent

A

thyme mass
-normally midline

38
Q

types of metabolic masses

A

gout, sarcoidosis, Kimora disease (chronic inflammation involving subcutaneous tissue) and castleman disease (lymphoproliferative disorder)

39
Q

teratoma

A

-from pluropotential cells and involves all 3 germ layers encapsulated with a cyst component
*this is a malignancy

40
Q

brachial cleft cysts

A

congenital epithelial cyst at the lateral part of the neck due to a failure to obliterate the second brachial cleft during development or trauma

41
Q

brachial cleft cysts s+s

A

anterior and upper neck swelling to sternocleidomastoid
-can have a fistula that is open to the skin
-surgery has risks

42
Q

dermoid cyst caused

A

by entrapment of the epithelium in deeper tissue during development or trauma
-nontender, midline

43
Q

hodge lymphoma

A

younger 15 ot 24, neck, axilla, chest MC, reed sterner cell, one of the most treatable cancers

44
Q

nonhodhge lymphoma

A

60s and up, lymph nodes throughout the body, dx typically at later stage

45
Q

lymphoma s+s

A

painless lymph node swelling at armpit, groin
-fever, fatigue, sob, weight loss

46
Q

viral sialadenitis

A

-mc: mumps, can also be abc, coxsackie, influence a, echovirus

47
Q

viral siadelitithis s+s

A

acute pain, swelling @ one or both parotid glands with a non specific prodrome
-feverm malaise, headache, anorexia within 48 hours of parotitis)

48
Q

HIV red flag

A

can be asymptomatic with non painful swelling if they have viral siadalithesis

49
Q

tb

A

chronic contender swelling of one parotid gland or a lump in the gland
-might or might not have tb s+s

50
Q

sjorn s+s

A

recurrent or chronic swelling one or both parotid glands with no apparent cause noted
-autoimmune
-discomfort, dry eyes and mouth

51
Q

central neck masses

A

mc: thyroglossal duct cyst
-hyoid bone
-cyst and thyroid carcinoma
-thymic rests and dermoids

Clinical medicine HEENT (10 decks)

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