Head and Neck

Question 1

polymyalgia rheumatica symptoms

pain and stiffness where? 
when are symptoms worse? 
generalized feelings? 
weakness? 
other conditions associated with PR? 
what lab would you take?

Answer 1

pain and stiffness in proximal muscles 
worse in morning and after prolonged inactivity 
fever, weight loss, fatigue, depression 
no weakness 
giant cell arteritis 
sedimentation rate

Question 2

giant cell arteritis symptoms

Answer 2

headache
temporal complaint
jaw claudication

Question 3

anterior cervical lymph nodes drain what

posterior cervical lymph nodes drain what

Answer 3

anterior - internal throat, posterior pharynx, tonsils, thyroid

posterior - skin on back of head and URI

Question 4

tonsillar lymph nodes drain what
submandibular lymph nodes drain what
submental lymph nodes drain what

Answer 4

tonsillar - tonsils, posterior pharynx

submandibular - floor of mouth

submental - teeth, intraoral cavity

Question 5

preauricular lymph nodes drain what

post auricular lymph nodes drain what

Answer 5

preauricular - eyes and external ear

postauricular - scalp

Question 6

occipital lymph nodes drain what

supraclavicular lymph nodes drain what

Answer 6

occipital - skin back of head

supraclavicular - thoracic cavity and abdomen

Question 7

does lypmphadenopathy occurs more locally or generalized

most common

Answer 7

locally

most common in head and neck

Question 8

what are you looking for on lymph node palpation

Answer 8

tenderness - pain or no pain
mobility - mobile or non mobile
texture - hard or soft

Question 9

what are possible findings on thyroid exam

Answer 9

diffuse enlargement
single nodule
multiple nodules
tenderness - thyroiditis

Question 10

what are symptoms of hypothyroid

Answer 10

fatigue 
cold intolerance 
weight gain 
depression/lethargic 
hair loss 
loss lateral 1/3 of eyebrow 
dry coarse brittle hair 
dry rough skin 
thin brittle nails 
cold hands and feet 
constipation 
puffiness around periorbital region 
enophthalmos 
heavy and more frequent menstruation

Question 11

what symptoms of hyperthyroid

Answer 11

heat intolerance 
weight loss 
nervousness, irritability, anxiety 
fine thin hair 
warm velvety smooth skin 
increased appetite 
tremors 
exophthalmos 
lid lag - eyelid lags behind globe movement on downward gaze 
increased basal metabolic rate 
light and less frequent menstruation 
muscle weakness

Question 12

what are happens to DTRs, pulse, and BP when talking about hyperthyroid and hypothyroid

Answer 12

DTRs, pulse, and BP increase in hyperthyroid

DTRs, pulse, and BP decrease in hypothyroid

Question 13

patient presents with fine hair, smooth skin, and exophthalmos

Answer 13

hyperthyroid

Question 14

patient presents with coarse hair, dry skin, and enophthalmos

Answer 14

hypothyroid

Question 15

what is the dominant thyroid hormone

Answer 15

T3

Question 16

what is the endocrine process of thyroid gland

Answer 16

hypothalamus - TRH
pituitary gland - TSH
thyroid gland - T3 and T4
tissues - T4 converted to T3

too much T3/T4 shuts down hypothalamus and pituitary gland from releasing

Question 17

thyroid symptoms occur when excess __ prevents what

why is the excess __ produced?

Answer 17

excess cortisol and CRH from hypothalamus

excess cortisol prevents T4 to T3 conversion in tissues
CRH prevents production of TSH from pituitary

excess cortisol is produced in response to stress, physiological trauma, infection, allergies, and dysbiosis

Question 18

what is the thyroid self test

Answer 18

barnes test

basal metabolic rate and temperature

normal range 97.8 - 98.2

hypothyroid - below 97.8
hyperthyroid - above 98.2

Question 19

what is a competitive inhibitor of T3

Answer 19

reverse T3

Question 20

giant cell arteritis symptoms

what is the cause

what vessels does the condition affect

are bruits common with this condition

treatment

Answer 20

jaw claudication, tender temporal region, headache

unknown cause

medium and large arteries

BRUITS are NOT common with this conditon

corticosteroids