Head and neck exam

Question 1

Neck lump differential

Answer 1

midline - gotier, thryoglossal cyst, parathyroid lump, lymph node
Anterior - brachial cyst, tumor, lymph node, lipoma, sebacous cyst

Posterior
-lymph node, cystic hydroma, sebacous cyst, lipoma

Question 2

Differentials goiter

Answer 2

• MNG
• graves
• hashimotos thryotoxicosis
• tumor
• thryoditits

Question 3

Causes of hypothyroidism

Answer 3

V
Iatrogenic - Surgery, drugs, radioiodine (lithium) 
T 
Autoimmune (hashimotos) , Acquired - iodine deifcencey 
M 
I 
N
Secondayr - pituritary problem

Question 4

Graves disease features

Answer 4

Hyperthryoid

Overall - thin, fidgety, flushed, sweaty, tremor
Eyes -exopthalmous, lid lag, opthalmoplegia
Midline neck lump - smooth,

Peripheral - pretibial myxoedema

tsh receptor antibodies

Question 5

Thyroid eye signs - hyper thryoid vs graves

Answer 5

Any cause of hyperthyroidism
! Lid retraction
! Lid lag
1 Specific to Graves’ disease
! Exophthalmos
! Ophthalmoplegia

Question 6

Causes of hyperthryoidism

Answer 6

• graves
• toxic MNG
• Toxic nodule
• hashimotis thryotoxicosis (inital phase)

Secondary - pituitary

-carcinoma

Question 7

Parotid swelling

Answer 7

• bacterial, viral, fungal
• TB
• alcohol

Question 8

Management hyperthryoid

Answer 8

-Medical - beta blcoekrs

Radioiodine
Surgical - thryodiectomy

Question 9

Contraindicaitons to radioiodine

Answer 9

• pregnacy.breast feeding
• young children at home
• incontience (becasue excreted with urien)

Question 10

Complciatiosn of thryoidectomy

Answer 10

Damage
Haemorraheg
Infection

Surrounding structure
-traceha, laryngeal , oesophagus, neck mucels

Hypoparthryodism