Head and Neck History Taking Flashcards

1
Q

List some of the most common symptoms in presenting complaint of an ENT patient.

A

Sore throat
Dysphonia- hoarseness
Dysphagia
Odynophagia
Mouth/throat ulcer
Neck lump

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2
Q

In which issues is family history particularly important?

A

Thyroid issues

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3
Q

Name the three major salivary glands

A

Parotid
Sublingual
Submandibular

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4
Q

Auscultation is rare in head and neck examination but when might this be done?

A

Thyroid bruits
Carotid bruits

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5
Q

In which condition would there be a thyroid bruits?

A

Grave’s thyroiditis

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6
Q

In which condition would there be a carotid bruits?

A

Carotid stenosis

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7
Q

What happens if you look in someone’s mouth and they have two uvula?

A

Don’t panic! Strange to see but no clinical significance.

But gal, this could be something they throw in an OSCE to see if you notice ig so be aware!

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8
Q

What is used in examination of the throat?

A

Flexible or rigid laryngoscope

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9
Q

What colour are normal vocal cords?

A

Pearly white

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10
Q

If a patient presents with a lump in their neck, which investigation will be carried out?

A

FNAC
Fine needle aspirate cytology

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11
Q

Which scan is useful for seeing areas of increased metabolic activity?

A

PET scan

->areas of increased metabolic activity may be tumours as require more blood and nutrients to grow.

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12
Q

Which questions will need to be asked if a patient presents with a lump in the neck?

A

How long has it been there?
Site?
Fluctuates in size?
Sore?
Associated head and neck symptoms.
Recent travel?

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13
Q

Upon examination of a neck lump, what should be checked?

A

Seven S’s

Site
Size
Shape
Soft or hard?
Sore
Skin over the lump
Stuck or fixed to any adjacent structures?

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14
Q

Describe the features of a reactive lymph node.

A

Oval
Soft
Smooth
Mobile
Tender

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15
Q

If a child has reactive lymph nodes, what may the child have?

A

Ear infection
Posterior nasal infection

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16
Q

What may salivary gland swellings be related to?

A

Tumours
Inflammation

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17
Q

What other problems can occur within the salivary glands?

A

Salivary stones

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18
Q

In someone with salivary stones, when will their salivary glands swell?

A

In relation to meals- as soon as they try to salivate, the gland will swell up

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19
Q

Which investigation can be used to find salivary stones and why?

A

X-ray as they as usually radio-opaque because of high calcium content

20
Q

If a patient presents with hoarseness, what would you want to ask of in past medical history?

A

Recent UTRI?

21
Q

What other questions may you ask regarding hoarseness?

A

How long?
Persistent or intermittent?
Pain?
Cough/swallowing/choking?
Asthma/rhinitis/reflux causing irritation to throat?
How much do they use their voice e.g. teacher or singer?
Smoke?
Medication?

22
Q

What are some benign causes of hoarseness?

A

Nodules
Cysts
Vocal abuse
Laryngitis
Smoking
Reflux
Infection

23
Q

What is a more worrying cause of hoarseness?

A

Laryngeal carcinoma

24
Q

What is the treatment for a laryngeal carcinoma?

A

Removal of voice box (larynx)
Could get a laryngectomy stoma where larynx is removed and trachea is stitched to the skin at the front of the neck.

25
Q

Which other cancer may present with hoarseness and why?

A

Lung cancer
May metastase to hilum of lung and compress recurrent laryngeal nerve

26
Q

List some questions to ask a patient presenting with dysphagia.

A

How long?
What is difficult to swallow?
Persistent or intermittent?
Pain?
Where do they feel food sticking?

27
Q

What could be an issue with the lumen of the oesophagus causing dysphagia?

A

Foreign body

28
Q

What could be an issue with the wall of the oesophagus causing dysphagia?

A

Stricture
Tumour
Pouch
Neuromuscular

29
Q

What could be an extra-luminal issue of the oesophagus causing dysphagia?

A

Thyroid
Heart
Mediastinal mass

30
Q

Which investigation may be carried out in someone with difficulty swallowing?

A

Barium swallow (contrast)

31
Q

What is Globus phartyngeus?

A

Feeling like there is something stuck in the throat when there isn’t anything there

32
Q

What is the cause of Globus phartyngeus?

A

Spasm of the Cricopharyngeus muscle

33
Q

What can trigger spasm of the Cricopharyngeus muscle and therefore cause Globus Phartyngeus?

A

Reflex
Recent infection
Postnasal drip
Anxiety/stress

34
Q

What is the most common type of malignancy in head and neck?

A

Squamous cell carcinoma

35
Q

List some common sites for cancer of the head and neck.

A

Oral cavity
Larynx
Oropharynx
Nasopharynx
Hypopharynx

36
Q

If someone has a nasopharynx cancer, what other related symptoms may they get?

A

Fluid in ear

37
Q

Describe what would be felt in a malignant node of the neck.

A

Firm
Round
Irregular
Fixed
Non-tender

38
Q

What is the symptom for airway obstruction?

A

Difficulty breathing

39
Q

What is a clinical sign of airway obstruction?

A

Stridor

40
Q

What are some of the causes of airway obstruction?

A

Tumours, foreign bodies, infection

41
Q

How would an airway obstruction be treated?

A

ABC
humidified oxygen, steroids, adrenaline nebuliser
Secure airway, may involve surgery

42
Q

Which surgery may be involved in the treatment of airway obstruction in cases of tumours?

A

Cricothyroidotomy or tracheostomy.

43
Q

What is a complication of tonsillitis?

A

Quinsy (abscess)

44
Q

When may a patient be offered tonsillectomy?

A

Bacterial tonsillitis
6-7 attacks in one year
Disrupting daily activities
More than one quinsy

45
Q
A