Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENT > HEAD AND NECK TUMOURS > Flashcards

HEAD AND NECK TUMOURS Flashcards

1
Q

Red Flag Presentations for Mucousal Tumours?

A
  • Dysphagia (difficulty swallowing)
  • Dysarthria (Difficulty speaking)
  • Dysphonia (hoarse voice)
  • Odynophagia (pain swallowing)
  • Referred Otalgia
  • Globus (sensation of mass in throat)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most Common Tumour type in Head /Neck Mucosa?

A

The most common tumour type in head and neck mucosa is Squamous Cell Cancer (SCC)

These can arise:

  • de novo
  • from premalignant lesions: leukoplakia or erythroplakia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Difficulty Swallowing?

A

Dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Difficulty Speaking?`

A

Dysarthria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hoarse Voice?

A

Dysphonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pain Swallowing?

A

Odynophagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sensation of Mass in Throat?

A

Globus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cause/Presentation/Treatment of Oral Cavity Mucosal Tumour?

A

_

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cause/Presentation/Treatment of Oropharygeal Mucosal Tumour?

A

_

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cause/Presentation/Treatment of Nasopharygngeal Mucosal Tumour?

A

_

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cause/Presentation/Treatment of Hypopharyngeal Mucosal Tumour?

A

_

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The larynx is bordered by:

  • ___________ superiorly
  • ___________ inferiorly
  • ________________ laterally and posteriorly.
A

The larynx is bordered by:

  • oropharynx superiorly
  • trachea inferiorly
  • hypopharynx laterally and posteriorly.

The larynx is the most complex of the mucosal lined structures of the head and neck.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Presentation/Treatment of various stages of Laryngeal Mucosal Tumour?

A

_

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Odynophagia + Dysphagia + visible mouth lesion?

Cause?

A

Oral Cavity Tumor

Causative agents include tobacco and occasionally Human papilloma virus (HPV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Painless neck mass due to cervical lymphadenopathy, odynophagia?

Cause?

A

Oropharyngeal Cancer

Causative agents: 70% Human papilloma virus (HPV) and less frequently tobacco smoking.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Painless neck mass due to cervical lymphadenopathy as well as nasal obstruction and epistaxis?

Subtypes/Causes?

A

Nasopharyngeal Tumour

Causes

Non-Keratinising Squamous Cell Carcinoma (NKSCC):

  • Epstein Barr Virus (EBV)
  • Genetic (HLA I&II)
  • Nitrosamines - food preservative used in salted fish

Keratinising Squamous Cell Carcinoma (KSCC): Smoking and alcohol exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Dysphagia and weight loss?

Cause?

A

Hypopharyngeal Mucosal Tumour

Risk factors: Smoking and a co-factor is alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Dysphonia, dysphagia, weight loss in advanced tumours?

Cause/Treatment of various stages?

A

Larynx Tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

____________________: Removal of the larynx and separation of the airway from the mouth nose and esophagus.

  • Consequences?
  • Indications
  • Complications?
A

Laryngectomy: Removal of the larynx and separation of the airway from the mouth nose and esophagus.

  • After this procedure a patient will be an obligate neck breather(cannot be oxygenated or intubated from the nose/mouth)
  • The patient will also have lost their vocal cords and will have lost the ability to phonate traditionally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Removal of the larynx and separation of the airway from the mouth nose and esophagus

A

Laryngectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Surgical formation of an opening into the trachea through the anterior neck especially to allow the passage of air

A

Tracheostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Indications for Tracheostomy?

A
  • Long term ventilation (facilitates weaning)
  • Upper airway obstruction e.g., tumour
  • Airway protection in loss of laryngeal reflexes e.g., neurological disease
  • Access for pulmonary toilet
  • As part of another procedure e.g., Laryngectomy
23
Q

Complications of Tracheostomy?

A
24
Q

Role/Use of the Cuff on Tracheostomy Tube?

A
25
Q

Role/Use of the Fenestrations on Tracheostomy Tube?

A
26
Q

Role/Use of the Canuli on Tracheostomy Tube?

A
27
Q

______________________

  • Mass
  • CN VII palsy or paralysis
  • Pain, trismus (lockjaw), skin paraesthesia (burning/prickling)
A

Salivary Gland Malignancy (Acinic cell carcinoma, Adenoid Cystic, Mucoepidermoid)

  • Mass
  • CN VII palsy or paralysis
  • Pain, trismus (lockjaw), skin paraesthesia (burning/prickling)

Lymphoma can present in salivary glands or in parotid lymph nodes

28
Q

Most common salivary gland malignancies

A
  1. Acinic cell carcinoma
  2. Adenoid Cystic
  3. Mucoepidermoid
29
Q

Acinic Cell Carcinoma

  • Characteristics
  • Most Common Salivary Gland
  • Treatment
A
30
Q

Adenoid Cystic

  • Characteristics
  • Demographic
  • Most Common Salivary Gland
  • Treatment
A

_

31
Q

Mucoepidermoid

  • Characteristics
  • Demographic
  • Most Common Salivary Gland
  • Treatment
A

_

32
Q

______________________ are the most common salivary gland mass

  • Malignant?
  • How do they present?
  • Treatment?
A

Pleomorphic Adenomas are a benign condition and most common salivary gland mass.

  • Present as a slow growing painless lump .
  • Firm, mobile and well circumscribed.
  • Surgically resected via parotidectomy
33
Q

Characteristics of Parotid Gland Tumours?

A
  • 80% of parotid gland tumors are benign
  • 80% are pleomorphic adenomas
  • 80% are found in the superficial lobe of the parotid gland
34
Q

Concerns of Malignant Transformation of Pleomorphic Adenoma?

What are they called when they progress?

A

Pleomorphic adenomas present as a slow growing painless lump. On examination, they are firm, mobile and well-circumscribed

Malignancy Concerns

  • Facial nerve is very rarely affected by pleomorphic adenomas. If present=> concern for a malignant process.
  • Rapid enlargement of a tumour nodule should raise concern about the development of malignant change
  • Risk of transformation is 10% over 15 years.
  • When they transform to malignant tumours they are called Carcinoma Ex-pleo and have a poor prognosis with a 5-year survival of 40%.
35
Q

Risk Factors/Clinical Presentation of Thyroid Malignancy?

A
36
Q

Investigations for Thyroid Maliganancy?

A

Investigations:

  • Clinical exam
  • US is modality of choice and gives risk stratification U1 – U5 with U5 being malignant
  • Haematology: Calcitonin/CEA for medullary, Thyroglobulin for Papillary
37
Q

____________________________:

  • Most Common type of thyroid maliganac (80%)
  • It is well differentiated and carries a good prognosis
  • several histological variants with varying degrees of
    behavior from mild to more aggressive tumor types.
  • 11% of patients present with metastases outside the neck and mediastinum.

Investigations/Treatment/Indication for Thyroidectomy?

A

Papillary Thyroid Cancer:

  • Most Common type of thyroid maliganac (80%)
  • It is well differentiated and carries a good prognosis
  • several histological variants with varying degrees of
    behavior from mild to more aggressive tumor types.
  • 11% of patients present with metastases outside the neck and mediastinum.
38
Q

When is a thyroidectomy indicated for Papillary Thyroid Cancer?

A
39
Q

__________________________________:

  • 10% of thyroid malignancies
  • Considered a well differentiated cancer
  • __________ at the time of surgery & frozen section cannot differentiate between benign and malignant

Metastasis?

Investigations/Treatment?

A

Follicular Thyroid Cancer:

  • 10% of thyroid malignancies
  • Considered a well-differentiated cancer (along with Papillary Thyroid Cancer)
  • Thy 3 at time of surgery & frozen section cannot differentiate between benign follicular and follicular cancer
  • 11% of patients with FTC have metastases beyond cervical/mediastinal area on initial presentation

Patients with FTC are more likely to develop lung and bone metastases than are patients with papillary thyroid cancer

40
Q

Patients with ___________________________ are more likely to develop lung and bone metastases than are patients with ____________________

A

Patients with Follicular Thyroid Cancer are more likely to develop lung and bone metastases than are patients with Papillary Thyroid Cancer

41
Q

More aggressive form of Follicular thyroid cancer that requires a total Thyroidectomy?

A

Hurtle Cell (Follicular Oncocytic)

+ Adjuvant Radioactive Iodine

42
Q

Monitoring of Pappillary and Follicular Thyroid Cancer?

A
  • Clinical History/Examination
  • Neck US is effective for local recurrence in thyroid cancers
  • Thyroglobulin is an accurate marker for disease recurrence.

Calcitonin/CEA for Medullary

43
Q

________________________________:

  • 1-3% of thyroid malignancies
  • Nodule like Differentiated thyroid cancer
  • History suggestive of Pheochromocytoma (__________+___________)
  • Can be De Novo or assc. w/ Multiple Endocrine Neoplasia (Mutations?)

Investigations/Treatment?

A

Medullary Thyroid Cancer:

  • 1-3% of thyroid malignancies.
  • Nodule-like Differentiated thyroid cancer
  • History suggestive of Pheochromocytoma (Flushing + Diarrhoea/loose stools)

De Novo
or
Multiple Endocrine Neoplasia

  • RET mutation (More RET = more aggressive tumor)
  • MEN 2a/2b, Familial Medullary (non M.E.N.)
44
Q

Monitoring for Medullary Thyroid Cancer?

A
  • Haematological: Calcitonin/CEA levels
  • Radiological with US, MRI, CT scanning

Thyroglobulin for Papillary/Follicular

45
Q

__________________________________: most severely de-differentiated tumors accounting for <2% of thyroid cancers. They carry a very poor prognosis.

A

Anaplastic Thyroid Cancer: most severely de-differentiated tumors accounting for <2% of thyroid cancers. They carry a very poor prognosis.

46
Q

Types of Thyroid Malignancy?

A

Four Major Subtypes of Thyroid Cancers:

  • Papillary (80%): Well Differentiated=> GOOD PROGNOSIS. Thyroglobulin Monitored
  • Follicular (10%): Well Differentiated=> GOOD PROGNOSIS. Bone/Lung Metastiasis Likely. Thyroglobulin Monitored
  • Medullary: Pheochromocytoma History. Calcitonin & CEA Monitored
  • Anaplastic (2%)- Poorest Prognosis
47
Q

Hyperparathyroidism Subtypes?

A
48
Q

Most common cause of hypercalcemia in hospitalized patients?

Diagnosis?

A

HYPERCALCAEMIA OF MALIGNANCY: Parathyroid hormone-related peptide (PTH-rP) secreted from tumours

Diagnosed by HIGH calcium levels with LOW PTH

49
Q

______________________: Slow-growing locally invasive malignant skin cancer arising from basal cells of the epidermis

  • Frequency
  • Risk Factors
  • Surgical Margins/Indication for Radiotherapy?
A

BASAL CELL CARCINOMA (BCC): Slow-growing locally invasive malignant skin cancer arising from basal cells of the epidermis

Frequency: Most common cancer (7th Decade, Exposed Skin)

Predisposing Factors

  • Exposure to UV radiation esp. in childhood
  • Gorlin Syndrome
  • Increasing age
  • Males
  • Fair skin types - Fitzpatrick I and II
  • Immunosuppression
  • Arsenic Exposure
50
Q

_____________________________: Locally invasive, malignant tumor arising from the keratinising cells of the epidermis and has the potential to metastasize to other organs of the body

  • Frequency
  • Risk Factors
  • Treatment?
A

Squamous Cell Cancers (SCC): Locally invasive, malignant tumour arising from the keratinising cells of the epidermis and has the potential to metastasize to other organs of the body

Frequency: 2nd Most Common Skin Cancer

Predisposing factors:

  • Chronic UV light exposure in sun-damaged skin
  • Fair skin
  • Albinism
  • Xeroderma pigmentosum
  • Ionising radiation
  • Arsenic exposure
  • Chronic wounds/ scars/burns/ulcers/sinus tracts
  • Bowen’s disease (intraepidermal SCC)
  • Immunosuppression
51
Q

___________: is a malignant tumour, which arises from cutaneous melanocyte

  • Risk Factors?
  • Subtypes?
  • Treatment/Surgical Marins?
A

Melanoma: is a malignant tumour, which arises from cutaneous melanocyte.

Risk Factors:

  • > 100 normal moles
  • Atypical moles
  • Family History of Melanoma
  • Freckles
  • Red hair or skin which burns in the sun

Treatment: by genotype of tumour (earliest cancers to benefit)

  • BRAF v600 +: Vemurafenib
  • Melanoma in Situ - 5mm margin
  • Thickness ≥ 1mm - 2cm margin
  • Thickness ≤ 1mm - 1cm margin
52
Q

Incidence of oropharyngeal cancer is greatly increasing due to ______________

A

Incidence of oropharyngeal cancer is greatly increasing due to HPV-induced tumours

HPV-mediated oropharyngeal disease carries a close to 60% reduction in death risk when compared to smoking-induced oropharyngeal cancers

53
Q

Factors influencing Squamous Cell Cancers (SCC) likeliness to metastasize?

A

Squamous Cell Cancers (SCC) (Locally invasive, malignant tumour arising from the keratinising cells of the epidermis)

  • Site: Sun Exposed (Lips> Ears > Non-sun exposed sites >
    Chronic ulcers, Radiation exposed sites)
  • Size: Tumours > 2cm - 3x more likely to metastasis
  • Depth: Tumours deeper than 4mm or extending into/beyond the subcutaneous tissue (Clark IV)
  • Patient immunosuppression
  • Recurrent disease
54
Q

ABCDE of Melanoma?

A

ENT (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions