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Surgery > Head & Neck > Flashcards

Head & Neck Flashcards

1
Q

Management for Follicular neoplasm or Suspicious for a follicular neoplasm on FNAB?

A

Lobectomy

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2
Q

Thyroid cancer histioptype with the poorest overall survival?

A

Anaplastic carcinoma

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3
Q

Given 7 to 10 days preop to decrese vascularity of thyroid ( lessen bleeding) and to lessen the risk of thyroid storm?

A

Lugol’s Iodine ( Potassium Iodide Saturated Solution)

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4
Q

Antithyroid drug preferred during pregnancy?

A

PTU ( Propylthiouracil)

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5
Q

Structures remove in radical neck dissection?

A
  1. Level I to V cervical nodes
  2. Spinal accessory nodes
  3. Internal jugular vein
  4. SCM muscle
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6
Q

Single most important test in the evaluation of thyroid nodules?

A

FNAB

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7
Q

Most accurate and practical diagnostic test to differentiate benign to malignant lesions of thyroid?

A

FNAB

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8
Q

Most common type of esophageal cancer world wide!

A

Squamous Cell Carcinoma

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9
Q

Procedure of choice for a Pituitary Tumor?

A

Transsphenoidal surgery

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10
Q

Cranial nerve involved in the Tic Doloreux

A

Trigeminal nerve

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11
Q

Management of middle ear and mastoid disease with cholesteatoma?

A

Radical mastoidectomy

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12
Q

Structures excised in composite resection?

A
  1. Primary tumor
  2. Cervical nodes
  3. Part of the mandible
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13
Q

Prognostic indicator in Medullary Thyroid Carcinoma Patients?

A

Calcitonin doubling time

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14
Q

Indications for post-op radiation therapy?

A
  1. Extranodal extension
  2. Perineural invasion
  3. Lymphovascular Invasion
  4. Positive Cervical Lymph nodes
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15
Q

Indications for surgical removal of nodular goiter?

A
  1. Suspicious for malignancy
  2. Symptoms of pressure
  3. Substernal extension
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16
Q

Treatment of choice in early stage tracheal neoplasm?

A

Surgery if completely resectable . Primary resection and anastomoses.

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17
Q

Vulnerability of esophagus to perforation?

A
  1. Lacks serosal layer
  2. Allows the smooth muscle to dilate with ease
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18
Q

Presentation of Calcium stone formation in hyperparathyroidism?

A
  1. Hypophosphatemia
  2. Increased calciuria
  3. Hypercalcemia
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19
Q

Most common etiology of primary hyperparathyroidism?

A
  1. Parathyroid adenoma 80%
  2. Prathyroid hyperplasia 15-20%
  3. Parathyroid carcinoma 1%
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20
Q

Cause of Secondary Hyperparathyroidism?

A
  1. Deficiency of vitamin D
  2. Uremia
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21
Q

Cause of tertiary hyperparathyroidism?

A

Long standing, severe, secondary HPT which has turned autonomous once the cause of secondary HPT has been removed.

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22
Q

A 30yo male complaining of a 6 cm hard, fixed, left mandibular mass with radiographic features of multi- loculated lesion in the parasymphyseal area is most likely suffering from?

A

Ameloblastoma

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23
Q

Most common thyroid cancer affecting young patients?

A

Papillary Thyroid Carcinoma

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24
Q

Which among the following types of thyroid cancer has the best prognosis?

A

Papillary

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25
Q

Most common nerve injured during parotidectomy?

A

Marginal mandibular nerve

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26
Q

The major advantage of neo-adjuvant radiotherapy for head and neck malignancies is?

A

Decrease recurrence after surgery

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27
Q

Thyroid cancer with the poorest overall survival is?

A

Anaplastic

28
Q

During parotidectomy, which structure can be used to identify the facial nerve?

A

Stylomastoid foramen

29
Q

Exit site of the facial nerve from the skull and landmark used in parotid surgery?

A

Stylomastoid foramen

30
Q

A 25yo known case of Graves disease is being given iodine for the last 10 days prior to surgery. Iodine was given in order to?

A

Minimize intraop bleeding

31
Q

Which is correct regarding carcinoma of esophagus?

A

Smoking is a risk factor

32
Q

Characteristic radiologic finding of an odontogenic ,painless, benign, locally aggressive tumor presenting with an Andy-Gump deformity?

A

Soap bubble-appearance

This is an ameloblastoma

33
Q

Predilection site of HPV positive Head and Neck Squamous Cell Carcinoma?

A

Oropharynx

34
Q

Cervical lymph node levels removed in a posterolateral neck dissection?

A

II, III, IV, V

Supraomohyoid : I, II, III
Lateral: II, III, IV
Central: VI

35
Q

Muscle that is superficial and parallel to the facial nerve?

A

Posterior belly of digastric

36
Q

Ligament that attaches the thyroid gland to the cricoid cartilage?

A

Ligament of Berry

37
Q

Prelaryngeal lymph nodes that group around the pyramidal lobe

A

Delphian nodes

38
Q

Possible injury in thyroid surgery that causes airway obstruction and necessitates tracheostomy?

A

Bilateral Recurrent Laryngeal Nerve Injury

Unilateral RLN injury: vocal cord in the paramedian position , normal but weak voice

Vocal cord in abducted position: hoarse voice , weak cough

39
Q

First muscle encountered during neck dissection?

A

Platysma

40
Q

Only test necessary in most patients with thyroid nodules that clinically appear euthyroid?

A

TSH

41
Q

Used for monitoring of differentiated thyroid cancer recurrence after total thyroidectomy and RAI ablation?

A

Serum thyroglobulin

42
Q

Used for monitoring of differentiated thyroid cancer recurrence after total thyroidectomy and RAI ablation?

A

Serum thyroglobulin

43
Q

Management of solitary thyroid nodule with an FNAB finding of suspicious for follicular neoplasia?

A

Lobectomy

44
Q

Features of Follicular carcinoma that can not be seen on FNAB?

A

Capsular & Vascular Invasion

45
Q

Hormone marker used for postoperative surveillance in Medullary Thyroid Carcinoma?

A

Calcitonin

46
Q

Technique used for the preoperative localization of the parathyroid glands?

A

Sestamibi scan

47
Q

Outcome of thymectomy in myasthenia gravis with thymoma?

A

25% resolve

48
Q

Acute painful visual loss without red eye?

A
  1. Pituitary apoplexy
  2. Acute onset of headache
  3. Nausea
  4. Visual field loss
  5. Ocular paresis
49
Q

Conditions that results in blindness?

A
  1. Glaucoma
  2. Uveitis
  3. Corneal ulcer
50
Q

Treatment for dry eye syndrome aka Keratoconjunctivitis sicca?

A
  1. Tear supplementation
  2. Environment coping strategies
  3. Application of warm compress
  4. Amelioration of eyelid abnormalities
51
Q

Contraindicated in Herpes Simplex Conjunctivitis?

A

Prednisone ophthalmic drops

Steroids could potentiate the infection

52
Q

Acute red eye with no loss of vision risk?

A

Subconjunctival hemorrhage

53
Q

Profuse purulent discharge from eye?

A

Gonococcal conjunctivitis

54
Q

Neck Dissections: Identify the levels being dissected.
Supraomohyoid Dissection

A

Levels I, II, III

55
Q

Neck Dissections: Identify the levels being dissected.
Lateral Neck Dissection

A

Levels II , III, IV

56
Q

Neck Dissections: Identify the levels being dissected.
Posterolateral Neck Dissection

A

Levels II, III, IV, V

For Thyroid Malignancies

57
Q

Neck Dissections: Identify the levels being dissected.
Thyroid Malignancies

A

Levels II, III, IV, V

58
Q

Neck Dissections: Identify the levels being dissected.
Laryngeal Malignancies

A

Levels II,III,IV

LATERAL NECK DISSECTION

59
Q

Neck Dissections: Identify the levels being dissected.
Oral Malignancies

A

Levels I, II, III

Supraomohyoid Dissection

60
Q

What level is the posterior triangle of the neck ?

A

Level V

61
Q

Tx for Medullary Thyroid CA with ret mutation carriers for MEN 2A?

A

Total Thyroidectomy before age 6

62
Q

Tx for Medullary Thyroid CA with ret mutation carriers for MEN 2B?

A

Total Thyroidectomy before age 1

63
Q

Preoperative localization test in primary hyperparathyroidism?

A

Sestamibi

64
Q

Hormone responsible for ductal development ?

A

Estrogen

65
Q

Hormone responsible for lobular development of the breast ?

A

Progesterone

66
Q

Fundoscopy of the affected eye shows cherry red spot over a pale background. What’s your diagnosis?

A

Central Retinal Artery Occlusion / Amaurosis fugax

Tx : direct infusion of thrombolytic to the ophthalmic artery or by decreasing IOP. ( IV acetazolamide or Vitreous Paracentesis)

Surgery (14 decks)

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