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IPAP Senior ENT > Head & Neck > Flashcards

Head & Neck Flashcards

1
Q

normal lymph node size

A

1cm

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2
Q

Enlarged lymph nodes are what size

A

> 1.5cm

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3
Q

rapid growth & tenderness of a lymph node suggests

A

inflammatory process

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4
Q

Slow growing / painless & firm lymph node suggests

A

neoplasm

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5
Q

neck mass rule of 7’s

A

7 days - infammatory
7 wks-7months - neoplastic
7 yrs - congenital

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6
Q

neck mass DDx in children to young adults

A

most benign

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7
Q

neck mass DDx in > 40y/o

A

MC cancer

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8
Q

neck mass DDx in < 30 & >70

A

consider Lymphoma

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9
Q

Most common neck space infection

A

Ludwig’s angina

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10
Q

Bilateral infection of submandibular space

A

Ludwig’s angina

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11
Q

Ludwig’s angina is typically caused by

A

dental infection

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12
Q

what is the most common cause of Deep neck abscesses

A

Odontogenic infections (dental)

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13
Q

what neck masses are considered ENT emergancies

A

Ludwigs angina

Deep neck Abscesses

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14
Q

what makes Ludwigs angina an ENT emergency

A

tongue is pushed up & back obstructing airway

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15
Q

This causes Ludwig Angina in ICU Pt’s?

A

Lemierre syndrome: Thrombophlebitis of IJV r/t IJ central line

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16
Q

suppurative lymphacdenopathy in middle aged Pt w/ tobacco/EtOH Hx should consider what

A

malignancy

(metastatic SCC) until proven otherwise

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17
Q

PE findings of Ludwigs Angina & Deep Neck Abcess

A

Edema
erythema
Pain upper neck under chin/floor of mouth
Tongue displace

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18
Q

MC bacteria for Ludwigs Angina & Deep Neck Abcess

A

Strep
Staph
Bacteroides
Fus

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19
Q

studies needed for Ludwigs Angina & Deep Neck Abcess

A

CT w/contrast

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20
Q

Tx of Ludwigs Angina

A

Penicillin + Metronidazole
Dental consult
External drainage if airway compromised

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21
Q

Tx of Deep Neck Abscess

A

secure airway (intubate / Trach)
IV ABX
I&D

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22
Q

Tx of Lemierre Syndrome

A

ABX for Fusobacterium

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23
Q

Most common cause of neck mass in any age

A

Reactive Cervical Lymphadenopathy (LAD)

24
Q

Reactive Cervical Lymphadenopathy (LAD) is a?

A

painful enlargement of lymph nodes respone to infection/inflammation

25
Q

Reactive Cervical Lymphadenopathy (LAD) is most commonly caused by infections of

A

pharynx
salivary glands
scalp

26
Q

when for consider FNA in Reactive Cervical Lymphadenopathy (LAD)

A

1) >1.5cm not associated w/ infection
2) H/o tobacco/EtOH/ or cancer
3) Persistent / continued enlargement

27
Q

Clinical presentation of Reactive Cervical Lymphadenopathy (LAD)

A

firm / mobile / tender

rapid increase in size

28
Q

older Pt w/ 1 enlarged lymph node, h/o TB exposure & POSITIVE TB. you should do what?

A

FNA Biopsy

anti-TB ABX 6-12 months

29
Q

young Pt w/ 1 enlarged lymph node, w/o h/o TB exposure & nonreactive PPD. what should you do?

A

FNA Biopsy

Surgical removal

30
Q

Pt gets 1 node enlargement wks-months after cat scratch what do you do

A

Self limiting may be Tx with ABX though

31
Q

immunocompetent Pt has single node enlargement in posterior triangle after eating under cooked meat

A

Toxoplasmosis;

ABX not needed

32
Q

Nodal enlargement in this area is highly suggestive of Syphilis?

A

Epitrochlear

33
Q

Tx of Syphilis

A

Pen G (2.4 million unit IM) once a week x 3 weeks

34
Q

What is snoring/OSA attributed to

A

narrow upper aerodigestive tract r/t position change/ muscle tone/ soft tissue hypertrophy/ laxity

35
Q

Signs/Sx’s of OSA

A

snoring
excessive daytime somnolence
daytime HA
weight gain

36
Q

A score > 10 on the Epworth Sleepiness Scale is?

A

abnormal suggestive of daytime sleepiness (EDS)

37
Q

Sleep study known as

A

Polysomnography

38
Q

Tx of OSA?

A

Weight loss/ position change
Mandibular advancement
CPAP/BiPAP
Surgical (UPPP)

39
Q

emergancy requiring intubation but unable to get should recieve what

A

cricothyrotomy

40
Q

Primary indications for Tracheotomy

A
  1. Airway obstruction @/above larynx

2. Respiratory Failure needing prolonged mechanical vent (MCC)

41
Q

what suggest foreign body in the esophagus & what imaging is needed

A

drooling

X-ray

42
Q

Treatment of foreign body in esophagus

A

non-sharp- 2hr monitor

endoscopic removal

43
Q

Most common congenital mas of lateral neck

A

Branchial Cleft Cyst

44
Q

A soft / slow-growing/ painless mass; appears along SCM/face/auricle that is non mid line & doesnt move when swallowing

A

Branchial Cleft Cyst

45
Q

Diagnosis of Branchial Cleft Cyst

A

CT cystic mass medial to SCM

46
Q

Tx of Branchial Cleft Cyst

A

Excise completely along w/ fistulous tract(s)

r/o malignancy

47
Q

Most Common congenital mas of central neck

A

Thyroglossal Duct Cyst

48
Q

20ish y/o Pt w/ midline mass below hyoid bone & will move w/ swallowing & tongue protrusion

A

Thyroglossal Duct Cyst

49
Q

Diagnosis of Thyroglossal Duct Cyst

A

TSH if abnormal –> thyroid scan

CT

50
Q

Tx of Thyroglossal Duct Cyst

A

Surgical removal of cyst & fistulous tract

51
Q

What does the Sistrunk procedure do

A

resection of Thyroglossal Duct to base of tongue w/ removal of cyst & medial segment of hyoid bone

52
Q

Most common Head and neck cancer

A

SCC

53
Q

suspected Head & Neck cancer Pt needs

A

ENT Consult

triple endoscopy

54
Q

What is included in triple endoscopy

A

direct leryngoscopy
Bronchoscopy
Esophagoscopy

55
Q

this is used to evaluate primary tumors

A

Endoscopy

56
Q

Presentation of SCC

A 
Sore throat
referred otalgia
hoarseness
\+/- airway obstruction
fixed reactive LAD, +/- tender
Constitutional Sx's
57
Q

group of cancer that present @ peak age of 20 & >50, multiple rubbery nodes

A

Hodgkins & nonhodgkins lymphoma

IPAP Senior ENT (7 decks)

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