throat

Question 1

what is a brachial cyst

Answer 1

development defect of branchial arteries –> cyst

Question 2

what are branchial cysts at increased risk of

Answer 2

fistula –> infection

Question 3

where/ when do branchial cysts present

Answer 3

12-18 // symptomatic lateral neck lump // anterior to sternocleoidomastoid mucle

Question 4

o/e branchial cyst

Answer 4

unilateral (usually left) // anterior to sternocleoidomastoid mucle // slow growing // smooth + fluctuating // non tender // do NOT move on swallowing

Question 5

invx branchial cyst

Answer 5

refer to ENT, USS +/- FNA (exclude cancer)

Question 6

how does thyroglossal cyst develop

Answer 6

thyroid develops from floor of pharynx and descends, connected to tongue by thyroglossal duct // duct normally atrophies but if not –> cyst

Question 7

symptoms thyroglossalcyst

Answer 7

patients <20 // midline between isthmus of thyroid _ hyoid // moves up with protrusion of tongue

Question 8

where do dermoid cysts occur

Answer 8

sites of embyronic developmental fusion - eg midline of neck

Question 9

which nerve may be damaged in thyroid surgery

Answer 9

recurrent largyngeal (branch of X)

Question 10

complication of bleeding in thyroid surgery

Answer 10

confined haematoma –> laryngeal oedema –> resp compromise

Question 11

what might damage to the parathyroid gland in thyroid surgery result in

Answer 11

hypocalcaemia

Question 12

causes of hoarseness

Answer 12

voice overuse // smoking // viral illness // hypothyrid // GORD // cancer

Question 13

early invx hoarseness

Answer 13

CXR for lung tumour (pancoast tumour on recurrent laryngeal)

Question 14

what is Laryngopharyngeal reflux

Answer 14

GORD –> inflamm changes of larynx

Question 15

symptoms Laryngopharyngeal reflux

Answer 15

globus (feeling of something stuck in throat) // hoarseness // cough // dysphagia

Question 16

red flag symptoms Laryngopharyngeal reflux

Answer 16

unilateral symptoms // dysphagia or odynophagia (pain with food> saliva) // persistent hoarseness

Question 17

mx Laryngopharyngeal reflux

Answer 17

PPI // gaviscon

Question 18

what causes reactive lymphadenopathy

Answer 18

infection

Question 19

symptoms lymphoma

Answer 19

rubbery, painless lymphadenopathy // pain on alcohol // night sweats + splenogemaly

Question 20

symptoms pharyngeal pouch

Answer 20

older men // dysphagia, regurg, aspiration, chronic cough, bad breath // neck swelling that gurgles

Question 21

what is a pharngeal pouch

Answer 21

herniation of pharynx

Question 22

invx + mx pharnygeal pouch

Answer 22

barium swallow –> surgery

Question 23

what is a cystic hygroma

Answer 23

kids <2 // left side of neck // soft, non-tender, transilluminates

Question 24

symptoms cervical rib

Answer 24

adult female // lump at bottom of neck // thoracic outflow syndrome - weak + numb arm

Question 25

symptoms head and neck cancer

Answer 25

neck lump // hoarseness // sore throat // mouth ulcer

Question 26

criteria for suspected laryngeal cancer referral

Answer 26

45+ + unexplained hoarseness OR unexplained neck lump