head and neck cancer

Question 1

red flags in head and neck

Answer 1

• neck lump
• sore throat
• difficulty swallowing
• stridor
• weight loss
• pain of swallowing
• referred ear pain
• hoarseness
• non healing ulcers
• unilateral nasal bleeding/obstruction

Question 2

what type of malignancy can cause a sore throat

Answer 2

• pharynx
• larynx
• neck

Question 3

nasopharynx cancer symptoms

Answer 3

• unilateral epistaxis
• unilateral nasal blockage
• mass in nasopharynx
• unilateral conductive hearing loss
• neck lump

Question 4

name 1 - 8

Answer 4

Question 5

what could a midline swelling be

Answer 5

• thyroid
• thyroglossal cyst
• dermoid cyst

Question 6

presentation fo thyroglossal cyst

Answer 6

• can arise in any part of the thyroglossal tract
• contains lymphatics which may become infected
• moves with tongue
• teens

Question 7

investigations of a solitary thyroid nodule

Answer 7

• TSH
• USS-FNA
• CT

Question 8

what can be some causes of anterior triangle swellings

Answer 8

• lymph nodes
• branchial cysts
• salivary glands
• carotid body tumour

Question 9

what to ask for cervical lymphadenopathy

Answer 9

• intermittent/progressive
• the duration
• fever? weight loss? night sweats? (tb?)
• cough, dyspnoea
• hoarseness
• always look for hepatosplenomegaly

Question 10

investigation for cervical lymphadenopathy

Answer 10

• CXR
• ENT optinion
• fine needle aspiration

Question 11

where do branchial cysts arise

Answer 11

in the upper part of anterior triangle

Question 12

what would you examine submandibular glands for

Answer 12

• stones

- pleomorphic adenoma

Question 13

what would you examine parotid gland for

Answer 13

• stones
• pleomorphic adenoma
• infection

Question 14

what is a paraganglioma

Answer 14

a type of neuroendocrine tumor that forms near certain blood vessels and nerves outside of the adrenal glands

Question 15

which virus is nasopharyngeal carcinoma related to

Answer 15

EBV

Question 16

which virus is oropharyngeal carcinoma related to

Answer 16

HPV

Question 17

presentation of oropharyngeal cancer

Answer 17

• dysphonia
• dysphagia
• odynophagia
• otalgia
• neck lump
• stridor

Question 18

where do supra-glottic tumours drain to

Answer 18

superior deep cervical nodes

Question 19

where do glottic tumours spread

Answer 19

most of them stay on the cords

-minimal lymphatic spread

Question 20

where do sub-glottal tumours spread

Answer 20

-paratracheal nodes

Question 21

how do you stage a head and neck tumour

Answer 21

CT neck and chest with contrast

Question 22

whats gold standard for investigating a neck lump

Answer 22

USS with fine needle aspiration

Question 23

what is MRI good for looking at

Answer 23

nasopharynx and tongue base

Question 24

laryngeal cancer management for stage 1 and 2

Answer 24

• transoral laser surgery

- radiotherapy

Question 25

management for stage 3 and 4 laryngeal cancer

Answer 25

• partial or total laryngectomy

- chemo and radiotherapy

Question 26

management for stage 1 and 2 oropharyngeal cancer

Answer 26

chemo-radiotherapy

transoral robotic surgery

Question 27

management for stage 3 and 4 oropharyngeal cancer

Answer 27

chemo-radiotherapy

Question 28

what are you more concerned about in a parotid lump

Answer 28

facial palsy or paresis

Question 29

is a mass in the parotid gland likely to be malignant or benign

Answer 29

benign

Question 30

most common adenoma in the parotid gland

Answer 30

pleomorphic adenoma

Question 31

which salivary glands are malignant tumours most likely to be found

Answer 31

submandibular and sublingual