Head and Neck conditions

Question 1

what is the most common pathological type of malignant tumour in the neck?

Answer 1

squamous cell carcinoma

Question 2

what is the most common benign tumour found in the neck?

Answer 2

pleomorphic adenoma

Question 3

what is the presentation of a pharyngeal pouch?

Answer 3

dysphagia
aspiration pneumonia/ complications
regurgitation
weight loss

Question 4

what are the characteristics of a reactive lymph node compared to a malignant lump?

Answer 4

lymph node will be oval, soft, tender, smooth

a malignant lump will be round, irregular, non-tender, hard

Question 5

what is the initial investigation of a suspected pharyngeal pouch?

Answer 5

barium swallow

Question 6

what is the initial investigation of a neck lump?

Answer 6

FNA cytology

Question 7

a patient presents with severe pain in his throat and right ear. he has difficulty opening his mouth and has extreme pain on swallowing.
what is the most likely diagnosis?

Answer 7

quinsy / peri tonsil abscess

Question 8

what is quinsy a complication of?

Answer 8

tonsillitis

Question 9

what is the most common cause of a head and neck cancer?

Answer 9

HPV

human papilloma virus

Question 10

what are risk factors for head and neck cancers?

Answer 10

smoking
alcohol
HPV

Question 11

a CT scan shows an intracranial abscess in an 18 month old patient.
What is the most likely condition that the abscess a complication of?

Answer 11

mastoiditis

Question 12

what is the most likely causative organism for otters externa?

Answer 12

pseudomonas aeruginosa

Question 13

if someone presents with a facial palsy, how would you differentiate between a stroke or bells palsy being the diagnosis?

Answer 13

Bells palsy = LMN therefore wouldn’t be able to move their eyebrows
Stroke = UMN therefore would be able to raise their eyebrows

Question 14

what is the condition for hearing loss due to old age?

Answer 14

presbycusis

Question 15

what is characterises of the hearing loss in presbycusis?

Answer 15

sloping sensorineural hearing loss

hear worse in higher frequencies

Question 16

a 2 year old patient presents with foul smelling unilateral nasal discharge. what is the most likely diagnosis?

Answer 16

foreign body

Question 17

what thyroid cancer is associated with famillial inheritance?

Answer 17

medullary thyroid cancer

Question 18

what thyroid cancer is associated with lymphatic spread and what type is associated with haematogenous spread?

Answer 18

follicular = haematogenous
papillary  = lymphatic

Question 19

a woman of 70 presents with a neck lump which is progressively getting larger. what is the most likely type of thyroid tumour?

Answer 19

anaplastic

associated with old age and aggressiveness

Question 20

what deficiency can cause diffuse thyroid swelling?

Answer 20

iodine deficiency

Question 21

what are the causes of diffuse thyroid swelling?

Answer 21

colloid goitre (adenomatous benign nodules)
thyroiditis
graves disease

Question 22

what is a colloid goitre what can cause it?

Answer 22

puberty
lactation 
pregnancy
gland hyperplasia
iodine deficiency

Question 23

what are the 7 S’s in the examination of a neck lump?

Answer 23

site 
size 
shape
soft 
stuck 
sore 
skin

Question 24

a patient presents with a feeling of a lump in his throat when he swallows and sometimes gets reflux. however the lump feeling eases when he swallows with food compared to water.
there shows to be no pathology.
what is this termed as and what causes it?

Answer 24

globus pharyngeus
feeling of a lump in the throat when swallowing
caused by stress/anxiety