Neck Flashcards
What is the definition of cervical lymphadenopathy?
The presence of a cervical lymph node >1cm.
Differentiate between the physical exam findings typical of viral lymphadenitis vs bacterial lymphadenopathy.
Viral lymphadenitis is typically bilateral, whereas bacterial lymphadenopathy is typically unilateral.
What is the most common cause of acute bilateral lymphadenopathy?
Viral infection, usually EBV or CMV.
List 7 bacterial causes of bacterial lymphadenopathy.
S. pyogenes (GAS), S. aureus, M. pneumoniae, A. haemolyticum, diphtheria, tuberculosis, and Bartonella henselae (cat scratch fever).
What are the most common bacterial pathogens responsible for acute unilateral bacterial lymphadenopathy?
S. pyogenes or S. aureus
What are the most common bacterial pathogens responsible for unilateral subacute/chronic bacterial lymphadenopathy?
Nontuberculous mycobacteria or Bartonella henselae (cat scratch fever)
What are the (4) most common malignant causes of cervical lymphadenopathy?
Neuroblastoma, leukemia, rhabdomyosarcoma, and Non-Hodgkin lymphoma.
List 5 non-infectious, non-malignant causes of cervical lymphadenopathy.
Juvenile idiopathic arthritis, collagen vascular diseases, drugs, serum sickness, and post-vaccination responses.
What is the recommended workup for cervical lymphadenitis?
CBC w/ diff, tuberculin skin testing, and serologic testing for B. henselae, CMV, EBV, and HIV. If those tests do not reveal the etiology, arrange for excisional biopsy to rule out malignancy and evaluate for nontuberculous mycobacteria.
What are some (8) causes of hoarseness in children?
Hoarseness in children is typically benign and can be caused by nodules, polyps, infection, papilloma, hypothyroidism, foreign body, congenital anomalies, and vocal fold granulomas (from GERD, intubation, or vocal cord misuse).
When would referral to ENT be appropriate in a child who presents with hoarseness?
If the hoarseness lasts >2 weeks then referral to ENT would be appropriate.
When is radiologic evaluation appropriate in a child who presents with hoarseness?
Radiologic evaluation is not typically necessary unless a foreign body or mass is suspected.
Which findings indicate possible malignancy when working up a neck mass?
The presence of hard, irregular, firm, immobile lymph nodes; nodes > 2 cm; or supraclavicular lymph nodes.
What disease would you suspect if a patient was noted to have parotid gland swelling that crossed the angle of the jaw?
Mumps
What abnormality would you suspect if a patient was found to have a neck mass midline between the hyoid bone and the suprasternal notch that moved with swallowing?
Thyroglossal duct cyst
