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Medicine - OSCE > Neck > Flashcards

Neck Flashcards

0
Q

Anterior triangle lump Ddx

A
  1. Brachial cyst (under top of SCM)
  2. Carotid body tumour
  3. Lymph node
  4. Sebaceous cyst
  5. Lipoma
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1
Q

Midline neck lump Ddx

A
  1. Goitre
  2. Glossopharyngeal cyst
  3. Lipoma
  4. Sebaceous cyst
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2
Q

Posterior triangle lump Ddx

A
  1. Cystic hygroma (above clavicle)
  2. Lymph node
  3. Lipoma
  4. Sebaceous cyst
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3
Q

Goitre Ddx

A
  1. Graves (diffuse)
  2. Multinodular goitre
  3. Solitary nodule
  4. Hashimoto’s thyroiditis
  5. Subacute thyroiditis
  6. Iodine deficiency 90%+
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4
Q

Hypothyroidism Ddx

A
  1. Autoimmune (primary atrophic thyroiditis - no goitre, hasimoto’s initially)
  2. Acquired (iodine deficiency, subacute thyroiditis,iatrogenic)
  3. Secondary ( panhypopituitarism)
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5
Q

Hyperthyroidism Ddx

A
  1. Graves
  2. Toxic MNG
  3. Toxic nodule (usually adenoma)
  4. Thyroiditis in the initial phase (hashimoto’s, post partum, subacute)
  5. Secondary (TSHoma, hydatidiform mole, choriocarcinoma)
    90% of cases will be due to 1-3.
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6
Q

Bilateral Parotid swelling Ddx

A
  1. Viral/bacteria parotitis
  2. TB
  3. Alcohol
  4. Pleomorphic adenoma
  5. Sjogren’s
  6. Sarcoidosis
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7
Q

Unilateral parotid swelling Ddx

A
  1. Duct blockage

2. Unilateral pleomorphic adenoma

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8
Q

MNG toxic vs non-toxic

A

Toxic - hyperthyroid
Non-toxic - euthyroid
MNG may be smooth to feel

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9
Q

Graves’ disease signs

A
  1. Goitre
  2. Thyrotoxicosis
  3. Eye disease (exophthalmos, opthalmoplegia)
  4. Pretibial myxodema
  5. Thyroid acropachy
    3-5 unique to graves
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10
Q

Graves vs MNG

A
  1. Smooth (MNG rarely smooth)
  2. Grave’s unique features
  3. TSH receptor antibodies
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11
Q

Graves indications for surgery

A
  1. Cosmetic
  2. Local compression
  3. Failed medical Rx
  4. Intolerant to medication
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12
Q

Hyperthyroid eye signs

A
  1. Lid retraction
  2. Lid lag
  3. Exophthalmos
  4. Opthalmoplegia
    3-4 specific to graves
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13
Q

Hyperthyroid Rx

A
  1. Medical (symptomatic - b blocker, anti-thyroid - carbimazole)
  2. Radioiodine
  3. Surgical (cosmetic, compression, malignancy) - total/partial thyroidectomy
    Carbimazole may cause bone marrow suppression
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14
Q

Contraindications for radioiodine

A
  1. Pregnancy/breast feeding
  2. Young children at home
  3. Incontinent (elimination in urine)
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15
Q

Early complications of thyroidectomy

A
  1. Anaesthetic
  2. Haemorrhage
  3. Infection
  4. Damage to surrounding tissue (recurrent laryngeal, trachea, oesophagus, neck musculature)
  5. Transient hypoparathyroidism
16
Q

Late complications of thyroidectomy

A
  1. Hypoparathyroidism
  2. Recurrent hyperthyroidism
  3. Hypothyroidism
17
Q

Brachial cyst - Ddx

A

Anterior triangle Ddx

  1. Cancer - thyroid, lymphoma, metastases
  2. Lymphadenopathy
  3. Lipoma/sebaceous cyst
  4. Goitre
  5. Salivary gland stone/cyst
  6. Thyroglossal duct cyst
18
Q

Bronchial cyst - investigation, management

A

Ix - CT neck, Fistulogram

Tx - surgical excision

19
Q

FNA vs Scintiscan

A

FNA - cold solitary nodules

Scintiscan - alternative

Medicine - OSCE (21 decks)

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