Neck Flashcards
0
Q
Anterior triangle lump Ddx
A
- Brachial cyst (under top of SCM)
- Carotid body tumour
- Lymph node
- Sebaceous cyst
- Lipoma
1
Q
Midline neck lump Ddx
A
- Goitre
- Glossopharyngeal cyst
- Lipoma
- Sebaceous cyst
2
Q
Posterior triangle lump Ddx
A
- Cystic hygroma (above clavicle)
- Lymph node
- Lipoma
- Sebaceous cyst
3
Q
Goitre Ddx
A
- Graves (diffuse)
- Multinodular goitre
- Solitary nodule
- Hashimoto’s thyroiditis
- Subacute thyroiditis
- Iodine deficiency 90%+
4
Q
Hypothyroidism Ddx
A
- Autoimmune (primary atrophic thyroiditis - no goitre, hasimoto’s initially)
- Acquired (iodine deficiency, subacute thyroiditis,iatrogenic)
- Secondary ( panhypopituitarism)
5
Q
Hyperthyroidism Ddx
A
- Graves
- Toxic MNG
- Toxic nodule (usually adenoma)
- Thyroiditis in the initial phase (hashimoto’s, post partum, subacute)
- Secondary (TSHoma, hydatidiform mole, choriocarcinoma)
90% of cases will be due to 1-3.
6
Q
Bilateral Parotid swelling Ddx
A
- Viral/bacteria parotitis
- TB
- Alcohol
- Pleomorphic adenoma
- Sjogren’s
- Sarcoidosis
7
Q
Unilateral parotid swelling Ddx
A
- Duct blockage
2. Unilateral pleomorphic adenoma
8
Q
MNG toxic vs non-toxic
A
Toxic - hyperthyroid
Non-toxic - euthyroid
MNG may be smooth to feel
9
Q
Graves’ disease signs
A
- Goitre
- Thyrotoxicosis
- Eye disease (exophthalmos, opthalmoplegia)
- Pretibial myxodema
- Thyroid acropachy
3-5 unique to graves
10
Q
Graves vs MNG
A
- Smooth (MNG rarely smooth)
- Grave’s unique features
- TSH receptor antibodies
11
Q
Graves indications for surgery
A
- Cosmetic
- Local compression
- Failed medical Rx
- Intolerant to medication
12
Q
Hyperthyroid eye signs
A
- Lid retraction
- Lid lag
- Exophthalmos
- Opthalmoplegia
3-4 specific to graves
13
Q
Hyperthyroid Rx
A
- Medical (symptomatic - b blocker, anti-thyroid - carbimazole)
- Radioiodine
- Surgical (cosmetic, compression, malignancy) - total/partial thyroidectomy
Carbimazole may cause bone marrow suppression
14
Q
Contraindications for radioiodine
A
- Pregnancy/breast feeding
- Young children at home
- Incontinent (elimination in urine)
15
Q
Early complications of thyroidectomy
A
- Anaesthetic
- Haemorrhage
- Infection
- Damage to surrounding tissue (recurrent laryngeal, trachea, oesophagus, neck musculature)
- Transient hypoparathyroidism
16
Q
Late complications of thyroidectomy
A
- Hypoparathyroidism
- Recurrent hyperthyroidism
- Hypothyroidism
17
Q
Brachial cyst - Ddx
A
Anterior triangle Ddx
- Cancer - thyroid, lymphoma, metastases
- Lymphadenopathy
- Lipoma/sebaceous cyst
- Goitre
- Salivary gland stone/cyst
- 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
