History Taking, Examination and Investigation Flashcards
What symptoms should be discussed?
- Sore throat
- Dysphonia (hoarseness)
- Dysphagia
- Odynophagia
- Mouth/throat ulcers
- Neck lumps
What are the 3 components of the pharynx?
- Nasopharynx
- Oropharynx
- Hypopharynx
What are the 3 components of the larynx?
- Supraglottis
- Glottis
- Subglottis
How should neck node levels be examined?
- Trace a Z
- Count to 5
What may you want to auscultate for?
- Thyroid bruit indicative of Grave’s thyroiditis
- Carotid bruits indicative of carotid stenosis
What are the key investigations for head and neck?
- FNAC
- CT/MRI/PET
- US
- Plain X-ray
- Contrast swallow
- Endoscopy
What should you ask about in the history of a neck lump?
- How long?
- Site?
- Fluctuates?
- Sore?
- H and N symptoms?
- B symptoms? (related to lymphomas)
- Travel?
What are the 7 Ss you are interested in when examining a neck lump?
- Site
- Size
- Shape
- Sore
- Skin
- Stuck
- Soft
What are the characteristics of a reactive lymph node?
- Oval
- Soft
- Smooth
- Mobile
- Tender
What do you want to ask about when it comes to someone who presents with hoarseness?
- How long?
- Persistent or intermittent?
- Pain?
- Cough/choking/swallowing?
- Voice use?
- Asthma, rhino sinusitis/reflux?
- Smoker?
- Medication?
What may hoarseness be due to?
- Nodules
- Cysts
- Vocal abuse
- Laryngitis
- Infection
- Smoking
- Reflux
- Laryngeal cancer
What do you want to know about the patient who presents with dysphagia?
-What is difficult?
-Persistent/intermittent?
-Pain?
-Where?
-
What may be the cause of dysphagia in the lumen?
Foreign body
What may be the cause of dysphagia in the wall?
- Tumour
- Stricture
- Neuromuscular
- Pouch
What may be the cause of dysphagia in the extra luminal space?
- Thyroid
- Heart
- Mediastinal mass
How is globus pharyngeus otherwise referred to?
FOSIT
-Feeling of something in throat
What are the characteristic of cricopharygeus?
- Acid reflux
- Strees/anxiety
- No dysphagia
- Not a red flag symptom
What can cause benign head and neck disorders?
- Congenital
- infective
- Inflammatory
- Trauma
- Neoplasia
What are the majority of cancers in head and neck?
Squamous carcinomas
What are the treatment options for head and neck cancers?
- Surgery
- Radiotherapy
- Chemotherapy
- Palliation
What are the characteristics of malignant neck nodes?
- Round
- Firm
- Irregular
- Fixed
- Non-tender
What is the main symptom of airway obstruction?
Difficulty breathing
What is the main sign of airway obstruction?
Stridor (noisy breathing)
What can cause airway obstruction?
- Infection
- Trauma
- Foreign body
How is airway obstruction managed?
- ABC approach
- Secure airway
- Humidified O2
- Steroids
- Adrenaline nebuliser
What are the SIGN guidelines on when tonsillectomy’s should be offered?
- Bacterial tonsillitis
- 6-7 attack in 1 year (5 per year over 2 years, 3 per year for 3 years)
- Disrupting daily activities
- More than 1 quinsy
