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ENT > head and neck cancer > Flashcards

head and neck cancer Flashcards

1
Q

most common site for squamous cell carcinoma

A

tonsil - present at an advanced stage

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2
Q

risk factors for tonsil SCC

A

smoking, high levels of alcohol intake and poor oral hygiene.

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3
Q

which organism is linked to tonsilar carcinoma

A

HPV

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4
Q

which organism is linked to nasopharyngeal or lymphoma

A

EBV

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5
Q

HIV individuals are at increased risk of developing which type of head and neck cancer

A

kaposi sarcoma

Non-hodgkin lymphoma

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6
Q

HTLV is associated with which virus

A

adult T cell leukaemia

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7
Q

features of head and neck cancer

A

neck lump
hoarseness
persistent sore throat
persistent mouth ulcer

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8
Q

criteria for laryngeal cancer 2 week referral

A

people aged 45 and over with:
persistent unexplained hoarseness or
an unexplained lump in the neck

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9
Q

criteria for oral cancer 2 week referral

A

unexplained ulceration in the oral cavity lasting for more than 3 weeks or
a persistent and unexplained lump in the neck.
Consider an urgent referral (for an appointment within 2 weeks) for assessment for possible oral cancer by a dentist in people who have either:
a lump on the lip or in the oral cavity or
a red or red and white patch in the oral cavity consistent with erythroplakia or erythroleukoplakia.

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10
Q

criteria for thyroid cancer 2 week referral

A

for thyroid cancer in people with an unexplained thyroid lump.

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11
Q

Gold standard Ix for parapharyngeal abscess

A

CT scan with IV contrast

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12
Q

what is nasopharyngeal carcinoma
type of cell
ass w

A

Squamous cell carcinoma of the nasopharynx
Rare in most parts of the world, apart from individuals from Southern China
Associated with Epstein Barr virus infection

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13
Q

systemic and local features of nasopharyngeal carcinoma

A

1) painless Cervical lymphadenopathy AS IT CAN SPREAD EASILY
2) Epistaxis
3) headaches
4) lymph node metastasis
5) unilateral hearing loss

Otalgia
Unilateral serous otitis media
Nasal obstruction, discharge and/ or epistaxis
Cranial nerve palsies e.g. III-VI

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14
Q

Ix for nasopharyngeal carcinoma

A

combined CT and MRI

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15
Q

treatment for nasopharyngeal carcinoma

A

radiotherapy

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16
Q

red flags in chronic rhinosinusitis

A

unilateral symptoms, epistaxis, blood-stained discharge, crusting, orbital symptoms (such as diplopia or reduced visual acuity), or neurological symptoms or signs.

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17
Q

premalignant lesions of the oral cavity

A

leukoplakia and erythroplakia

18
Q

risk factors of oral cavity cancer

A 
Smoking
alcohol  
Chronic dental infection, e.g. caries, may result in malignant change
tertiary syphilis.
Betel nut
19
Q

risk factors for carcinoma of the lip

A

outdoor workers
near the equator
tobacco smokers

20
Q

clinical features

A

lower lip
Dyskeratosis - white patch - ‘actinic chelitis’
ulcer look alike

21
Q

DD for lip ulcer

A

keratoacanthoma, syphilis and tuberculosis

22
Q

Ix for lip cancer

A

biopsy

23
Q

management for lip cancer

A

lip shave

radical neck dissection - metastatic nodal disease

24
Q

clinical features of tongue cancer

A

persistent ulcer, painless

if the lesion grows - tongue fixation and invade the mandible

inflamed gland on the contralateral side

25
Q

clinical features of head and neck cancer

A

neck lump
hoarseness
persistent sore throat
persistent mouth ulcer

dysphonia

  • dysphagia/odynaphagia
  • dyspnoea - stridor from narrowing of airway, esp laryngeal tumors
  • neck mass
  • pain from site of pathology or referred eg. to ear
  • bleeding from nose or mouth depending on site of primary (rare presentation)
  • nasal blockage - normally unilateral progressive for nasal/nasopharyngeal pathology
26
Q

histopathology of head and neck cancer

A

SCC

27
Q

risk factors of Head and neck cancer

A

alcohol
tobacco
beetle nut
chinese ethnic origin for nasopharyngeal malignancy

28
Q

Ix for primary tumor site in H&N cancer

A

1) examination under anaesthetic
- panendoscopy or laryngopharyngo-oesophagoscopy in H&N
- purpose - biopsy for histo diagnosis, assess size of tumour, look for secondary primary

2) CT neck
- purpose - assess size of tumour and neck node metastasis

29
Q

Ix of neck metastasis for H&N cancer

A

CT

not possible then do FNA

if primary unknown then do FNA

30
Q

Ix for distant metastasis in H&N cancer

A

CT chest

31
Q

management of H&N cancer

A

Radiotherapy
surgery
- endoscopic
- open surgery

32
Q

important cause if oropharyngeal cancer

A

HPV infection

33
Q

what is paterson-brown kelly syndrome / Plummer-vision syndrome

A

hypochromic microcytic anaemia, glossitis, koilonychia, splenomegaly and a postcricoid web with dysphagia

low iron

34
Q

clinical features of hypopharyngeal neoplasia

A 
otalgia
enlarged neck node
dysphonia
resp difficulties
dysphagia
weight loss
35
Q

Ix for hypopharyngeal neoplasia

A

barium swallow

36
Q

name of the benign nose tumor

A

angiofibroma

37
Q

names of the malignant nose tumor

A

carcinoma
non-hodgkins lymphoma
chrodroma

38
Q

what is saguineous discharge

A

bloody discharge indicating SCC

39
Q

features of post-cricoid tumors

A

sensation of lump
local pain
otalgia

anameia signs - chelitis

40
Q

pulsatile tinnitus
hearing normal
promotory in th emiddle ear behind TM

A

glomus tumor

41
Q

what are glomus tumor

A

benign tumors in the carotid arteries

42
Q

what is cricoarytenoid

A

rotate with the vocal chords

ENT (15 decks)

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