Neck Lump

Question 1

what is cervical lymphadenopathy

Answer 1

lymph node which has a considerable capacity to increase in size dependent age, infection etc

benign and self-limiting disease (viral or bacterial infection)

Question 2

RF for cervial lymphadenopathy

Answer 2

age
tobacco
smoking
alcohol

Question 3

what can cause cervical lymphadenopathy

Answer 3

bacterial - beta haemolytic streptocci, staph aureus, TB and secondary syphilis

viral - upper resp tract infection - EBV, cytomegalovirus, HIV, herpes simplex virus

parasitic - head lice, fungal infection, toxoplasmosis

non-infective - sarcoidosis and connective tissue tissue

others - malignancy lymph nodes - luekaemia, lymphoma, metastases, absecess, infected sebaceous cyst, lip-oma, thyroid swelling

in chilcdren - cat scratch disease, Kawasaki disease

Question 4

presentation of cervical lymphadenopathy

Answer 4

lymphadenopathy

Question 5

what are some red flags symptoms that can be mistaken for cervical lymphadenopathy

Answer 5

persistent fever, night sweat, general malaise or weight loss

Question 6

signs of cervical lymphadenopathy

Answer 6

Supraclavicular and infraclavicular lymph nodes are always suspicious of an underlying malignancy

look for signs of infections
examine ENT areas
examine mouth - for maglinancy, dental issues

Question 7

investigation for cervical lymphadenopathy

Answer 7

FBC, blood film 
ESR CRP 
LFT 
swabs if infection 
viral serology
blood cultures

Question 8

treatment for cervical lymphadenopathy

Answer 8

depends on cause, 2 weeks referral if red flag symptoms

Question 9

what are the major salivary glands

Answer 9

parotid glands, submandibular and sublingual glands

Question 10

where is the most common place for a tumour to arise in the salivary system

Answer 10

parotid glands - 80%

Question 11

what can cause salivary glands swelling

Answer 11

sialadenitis (infection of the salivary glands) - acute = viral, bacterial = staph auerus, strep pyogenes, strep pneumonia

obstruction - mostly due to stone

sarcoidosis

neoplasms

Question 12

RF for salivary gland swelling

Answer 12

age

radiation to the neck, smoking

stricture

Question 13

presentation for salivary glands swelling

Answer 13

facial palsy with a salivary mass = malignancy

pain
palpatable massess in the glands
larngeal salivary glands - airway obstruction, dysphagia hoarseness

Question 14

signs of salivary glands swelling

Answer 14

Bimanual palpation of the lateral pharyngeal wall for deep lobe parotid tumours and the extent of submandibular and sublingual masses

malignancy = 7th CN signs

Question 15

investigation for salivary glands swellings

Answer 15

normal bloods

X-ray and sialography might show stones

USS

CT/MRI

Question 16

treatment for salivary glands swellings

Answer 16

surgical removal