Throat

Question 1

Biggest risk factors for upper area-digestive tract cancers?

Answer 1

Smoking and alcohol

HPV 16-18 (oropharyngeal)
EBV (nasopharyngeal )

Question 2

Red flags and 2 week waits in head and neck cancer

Answer 2

Laryngeal Ca - over 45 persistent hoarseness or unexplained neck lump

Persistent Hoarseness >6wks
Ulceration oral mucosa > 3wks
Oral swelling > 3wks
Red and white patches
Dysphagia >3weeks 
Unilateral nasal obstruction
Unexplained tooth mobility
Unresolvimg neck mass >3wks
Orbital mass 

Smokers and over 45 - higher suspicion

Question 3

Diagnosis for head and neck cancer?

Answer 3

One stop clinic,
hx and examination
Nasendosopy, imaging, biopsy (cytology and histology)

Question 4

What’s the platysmata muscle of the neck?

Answer 4

Most superficial - wrinkles the neck, helps venous return,

Question 5

Causes of oral glandular swellings?

Answer 5

Stones (sialoliths) - most common
Infection (sialadenitis) - bacterial or viral
Cysts
Tumours 
Sjogrens - about 50% have gland swelling

Question 6

What is a brachial cleft cyst?

Answer 6

Congenital epithelial cyst (from 2nd cleft)

Painless fluctant mass in anterior triangle

Question 7

How to diagonose a thyroid problem?

Answer 7

Radioisotope scan (iodine) for function and size
Ct or mri if suspicious
Biopsy

Question 8

Which age group get thyroglossal cysts?

Answer 8

<20years

Question 9

What age group have cystic hygromas?

Answer 9

Birth-2 years old.

Classically on the left side - soft swelling, fluctuant, highly transilluminable

Question 10

How does Hodgkin lymphoma present?

Answer 10

Lymphadenopathy (rubbery, large, non-tender)
Systemic - weight loss, fever, night sweats
Alochol pain

Biopsy - reed-sternburg cells = mirror image nuclei

Question 11

How does achalasia present?

Answer 11

Difficulty swallowing food and liquid
Regurgitation
Heartburn

Question 12

How does globus hystericus (pharyngis)present?

Answer 12

Painless and intermittent
Relieved by swallowing
Swallowing saliva is more difficult
Hx of anxiety

Question 13

How do you treat necrotising ulcerative gingivitis?

Answer 13

Oral metronidazol
Chlorhexidine mouth wash
Simple analgesia

Refer to dentist

Question 14

What is characteristic above medullary thyroid cancer?

Answer 14

Parafollicular cells produce calcitonin and it can be used as a tumour marker

Linked to MEN2 syndrome (may have pheochromocytoma)

Question 15

Most common thyroid cancer?

Answer 15

70% PapillAry (good prognosis)

20% follicular

Question 16

Worse prognosis thyriod cancer?

Answer 16

Anaplastic

Question 17

What is cat scratch disease?

Answer 17

Bartonella infection - intracellular bacteria causing tender lymphadenopathy within 2 weeks of scratch

Question 18

Which gland do most sialolithiasis effect in the mouth?

Answer 18

Whartons duct (a submandibular location)

Question 19

Where is a cystic hygroma found anatomically?

Answer 19

Posterior neck triangle (sternocleidomastiod, trapezius, and clavicle)