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Lancaster FINALS _slide > Surgery (1) > Flashcards

Surgery (1) Flashcards

1
Q

Potential causes of neck lump in lateral anterior triangle

A

Lateral anterior triangle

Pulsatile

  • Carotid artery (tortuous/aneurysm)
  • Chemodectoma

Non-pulsatile

  • Sebaceous cyst/lipoma
  • Salivary gland
  • Lymphadenopathy
  • Brachial cyst
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2
Q

Potential causes of neck lump in midline anterior triangle

A

Midline anterior triangle

•Goitre

  • Thyroid mass
  • Thyroglossal cyst
  • Dermoid cyst
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3
Q

Potential causes of neck lump in the posterior triangle (3)

A
  • Cystic hygroma
  • Cervical rib
  • Lymphadenopathy
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4
Q

Causes of hyperthyroidism

A

• Graves’ Disease – autoimmune

(Triad of goitre, eye signs and thyrotoxicosis)

  • Toxic multinodular goitre
  • Thyroid adenoma
  • Ectopic thyroid tissue
  • De Quervains thyroiditis
  • Iatrogenic – drugs
  • Postpartum
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5
Q

What’s anterior neck triangle?

A
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6
Q

Borders of posterior neck triangle

A
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7
Q

Ix for suspected hyperthyroidism

A
  • Bedside: ECG (tachycardia/AF)
  • Bloods: TFTs (low TSH, high T3), Autoantibodies (anti-TSH), FBC (anaemia), HbA1c (associated diabetes), lipids
  • Imaging: USS Scan thyroid (if lump)
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8
Q

Management of hyperthyroidism

  • conservative
  • medical
  • surgery (+indications)
A
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9
Q

Thyroidectomy

  • complications
A

• Bleeding (dual blood supply from

superior and inferior thyroid artery)

  • Damage to Parathyroid (low PTH) →↓Ca2+
  • Damege to Recurrent laryngeal nerve

(hoarseness)

• Late hyperthyroidism

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10
Q

Match these to answers

A
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11
Q

Types of thyroid cancer

A
  • Papillary Ca → mets via the lymph
  • Follicular Ca → mets via the blood
  • Anaplastic → acute aggressive
  • Medullary → associated with MEN II
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12
Q

What’s the most common tumour of the parotid gland?

A

Pleomorphic adenoma – small non-progressive tumour

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13
Q

What clinical features distinguish a benign from a malignant salivary gland tumour?

A

Facial nerve involvement

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14
Q

What are the complications of the surgery to parotid gland?

A
  • Damage to the facial nerve
  • Frey’s syndrome - gustatory sweating due to divided parasympathetic nerves
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15
Q

Triad of Grave’s disease

A
  • thyrotoxicosis
  • goitre
  • eye signs
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16
Q
A
17
Q

Risk factors for breast cancer

A
  • BRCA genes - 40% lifetime risk of breast/ovarian cancer
  • Family history 1st degree relative premenopausal relative with breast cancer (e.g. mother)
  • nulliparity, 1st pregnancy > 30 yrs (twice risk of women having 1st child < 25 yrs)
  • early menarche, late menopause
  • HRT
  • combined oral contraceptive use
  • past breast cancer
  • not breast feeding
  • obesity
18
Q

What triple assessment consist of?

A
  1. History and Clinical Examination
  2. Radiology
  • < 35 years = USS
  • > 35 years = USS + Mammography
  1. Histopathology
  • Solid tumour – core biopsy
  • Cystic lumo – Fine Needle Aspraition
19
Q

Types of breast tumours

A
20
Q

Clinical staging of breast cancer

A

Stage 1: confined to breast, mobile, no lymph nodes

Stage 2: Stage 1 + nodes in ipsilateral axilla

Stage 3: Stage 2 + fixation to muscle (not chest wall). LNs fixed.

Stage 4: Complete fixation to chest wall and metastases

21
Q

Clinicopathological features of breast cancer (3)

A
  1. Clinical staging
  2. Oestrogen receptor status
  • Majority are oestrogen dependent
    • respond to hormonal therapy and carry a better prognosis
  1. HER2 receptor status
  • Found in 20 of invasive cancers
  • Associated with a poor prognosis
22
Q

Management of breast ca if carcinoma in situ

A

Breast-conserving surgery with 2 cm margin

23
Q

Management of breast ca if stage 1 or stage 2

A
  • Surgery with adjuvant therapy
  • Radiotherapy if wide local excision
    • Tamoxifen for oestrogen + if premenopausal
  • Aromatase inhibitors if post -menopausal
  • Herceptin if HER2 positive
24
Q

Management of breast cancer if stage 3 or 4

A
  • Chemo with palliation
  • Tamoxifen for oestrogen + if premenopausal
  • Aromatase inhibitors if post-menopausal
25
Q

Mastectomy vs wide local excision

A

Lancaster FINALS _slide (31 decks)

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