Head and neck Flashcards
33yo male presents with a white lesion of his oral mucosa. He is a smoker
Leukoplakia
A male smoker presents with oral pain and a persistent sore throat and dysphagia. On examination a neck mass is noted
Oropharyngeal SCC
A 10yo boy presents with a fever, sore throat and painful swallowing. He does not have a cough. Pus is noted on his tonsils on examination
Tonsillitis
A 26yo female presents with dry eyes and dry mouth. Schirmer’s test is positive
Sjogren’s syndrome
A patient presents with unilateral tonsil swelling
Quinsy
A 62yo male presents with a slowly enlarging, non-tender facial mass. The tumour is determined to be the most common head and neck tumour
Salivary gland tumour
A 22yo female presents with a 7 day history of facial pain with associated nasal congestion and hyposmia. Her symptoms resolve 2 days later without antibiotics
Acute sinusitis (viral)
A 36yo woman presents with facial pain over her sinuses, nasal congestion and a headache. She has had these symptoms for about 3 months
Chronic sinusitis
A 24yo male with chronic sinusitis presents with bilateral nasal obstruction. After rhinoscopy, intranasal corticosteroids are prescribed
Nasal polyps
A 65yo known smoker presents with progressive hoarseness and dysphagia
Carcinoma of the larynx
A 30yo patient presents with a neck mass. The mass is unilateral and is smooth, fluctuant and non-tender on palpation
Branchial cleft cyst
An 8yo boy presents with otalgia and tragal tenderness. On examination, the ear canal is swollen and inflamed
Otitis externa
A 12 month old boy presents tugging at his ear and with a fever for 1 day. Otoscopy is performed
Acute otitis media
A 3yo boy shows delay in language development. His mother admits that he had many ear infections as a child. What is the likely cause of this language impairment?
Chronic otitis media with effusion causing hearing loss
A 34yo Aboriginal man presents with hearing loss and otorrhoea. Otoscopy is performed as shown
Cholesteatoma
A 45yo patient presents with sudden unilateral hearing loss that began 4 days previously. Audiology reveals hearing loss in more than 3 frequencies of at least 30dB
Sudden sensorineural hearing loss
A 55yo female patient presents with vertigo. Upon further questioning, she reveals the vertigo comes on when she is in bed, typically lasts about 20 seconds and is severe
BPPV
A 40yo patient presents with episodic, sudden onset vertigo. The vertigo usually lasts about 2 hours.
She also complains of a feeling of fullness in her ears and tinnitus of a roaring quality.
Meniere’s disease
A 22yo presents with trouble seeing. Visual acuity reveals 6/12 in each eye. This is corrected by pinhole
Refractive error
A 5yo child presents with red eye and purulent discharge from his eyes. His eyelids are stuck together in the morning
Conjunctivitis (bacterial)
A 44yo patient with known IBD blurred vision and watery discharge. They have dull pain in the orbital region that is tender to palpation and some photophobia
Anterior uveitis
A 72yo male presents complaining of blurred vision and says that he does not feel he sees colours as brightly. Slit lamp examination of the anterior chamber reveals the pathology
Cataracts
A patient with known hypertension presents for an eye examination. This appearance is seen on fundoscopy
Hypertensive retinopathy (grade IV)
A patient with known diabetes presents to their optometrist. On questioning they report seeing an occasional floater and mild decrease in visual acuity
Diabetic retinopathy (proliferative)
A 78yo patient presents complaining of blurred vision. Choroidal neovascularisation is noted on fundoscopy
Wet macular degeneration
An 82yo smoker presents with blurred vision. Fundoscopy is performed
Dry macular degeneration
A patient presents with a headache, drowsiness and nausea. Fundoscopy is performed
Papilloedema
A 64yo patient presents with gradual vision loss. There is no associated pain.
Opthalmoscpopy reveals optic nerve cupping and retinal haemorrhage
Open-angled glaucoma
A female patient presents with rapid vision loss that she describes as tunnel vision. Her eye appears red and the cornea is cloudy and oedematous.
She also has associated headache, nausea and vomiting
Closed-angle glaucoma
A patient presents with unilateral lid closure. The affected eye appears “down and out”. What CN nerve is affected?
CNIII palsy
Causes: compressive, vascular, trauma, vasculitis, demyelinating disease, idiopathic
A patient presents with difficulty reading, on examination. The patient has vertical and torsional diplopia. What CN is affected?
CNIV palsy
Causes: trauma, microvascular disease, tumour, demyelination, vasculitis, idiopathic, congenital
A patient presents with double vision on right lateral gaze. What CN is affected?
CNVI palsy
Causes: vascular, raised ICP, tumours, trauma, demyelinating, vasculitis, idiopathic
