Head and Neck Lumps Flashcards by K D

Q

Examination of a lump

A

6 ‘S’ examination:

Site
Size
Shape
Smoothness
Surface
Surroundings

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Q

Examining surface of a lump

A

Contour

Edge

Colour

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Q

Other aspects of lumps to examine

A

Trans-illumination

Temperature

Tender

Pulsatile

Fixed/mobile

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Q

Lipoma definition

A

Benign fatty pump

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Q

Ganglia definition

A

Degenerative cyst from adjacent joint

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Q

Common site for ganglia

A

Dorsum of wrist

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Q

Mx of ganglia

A

50% disappear spontaneously

Otherwise excision

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Q

Fibroma location

A

Under the skin

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Q

Fibroma components

A

Collagen

Fibroblasts

Fibrocytes

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Q

Dermoid cyst location

A

Midline

Above hyoid

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Q

Thyroglossal cyst location

A

Midline

Below hyoid

Moves with tongue protrusion

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Q

Branchial cyst location

A

Anterior triangle

Under angle of mandible

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Q

Branchial cyst contents

A

Fluid with cholesterol crystals

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Q

Mx of branchial cyst

A

Excision

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Q

Cystic hygroma location

A

Posterior triangle

Trans-illuminate

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Q

Pharyngeal pouch

A

May protrude into posterior triangle on swallowing

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Q

Most common parotid tumour

A

Pleomorphic adenoma

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Q

Signs of parotid tumour malignancy

A

Ear deflected outwards

Facial nerva palsy

Parotid swelling present > 1 month

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Q

Types of goitre

A

Diffusely enlarged

Nodular

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Q

Causes of diffuse goitre

A

Iodine deficiency

Congenital

Acute thyroiditis

Autoimmune

Physiological

Q

Physiological causes of diffuse goitre

A

Pregnancy

Puberty

Q

Autoimmune causes of diffuse goitre

A

Graves’ disease

Hashimoto’s thyroiditis

Q

Causes of nodular goitre

A

Multi-nodular goitre (common)

Single nodule

Plummer’s disease (rare)

Q

Plummer’s disease definition

A

Hyperthyroidsim due to single toxic nodule

Q

Ix for goitre

A

TFTs

Thyroid auto-antibodies

USS

Radionuclide scans

Cytology

Q

Causes of single thyroid nodules

A

Cyst

Adenoma

Malignancy

Q

Hyperfunctioning (hot) nodule on radionuclide scan

A

Adenoma

Q

Hypofunctioning (cold) npdule on radionuclide scan

A

Malignancy

Q

Types of thyroid cancer

A

Papillary

Follicular

Medullary

Lymphoma

Anaplastic

Q

Papillary thyroid cancer epidemiology

A

Younger patients

Q

Papillary thyroid cancer spread

A

Lymph nodes

Lung

Q

Mx of papillary thyroid cancer

A

Total thyroidectomy

Q

Follicular thyroid cancer epidemiology

A

Middle age

Spreads early

Well differentiated

Q

Follicular thyroid cancer spread

A

Bone

Lungs

Q

Mx of Follicular thyroid cancer

A

Total thyroidectomy

Q

Medullary thyroid cancer epidemiology

A

MEN syndrome

Or sporadic

Q

Marker for Medullary thyroid cancer

A

Calcitonin

Q

Mx of Medullary thyroid cancer

A

Thyroidectomy

Q

Lymphoma thyroid cancer presentation

A

Stridor

Dysphagia

Q

Histology for lymphoma thyroid cancer

A

Possible MALT origin

Mucosa associated lymphoid tissue

Q

Anaplastic thyroid cancer epidemiology

A

Elderly

Poor response to any Rx

Q

Early complications of thyroid surgery

A

Recurrent laryngeal nerve palsy

Haemorrhage

Hypoparathyroidism

Thyroid storm

Q

Late complications of thyroid surgery

A

Hypothyroidism

Failure

Q

Salivary stone sx

A

Recurrent unilateral pain and swelling

No infection signs

Q

Most common site of salivary stone

A

Submandibular gland

Q

Ix for salivary stones

A

X ray

Sialography

Q

Mx of distal salivary stones

A

Removed via mouth

Q

Mx of deeper salivary stones

A

Possible gland excision

Q

A