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44 Cards in this Set
- Front
- Back
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What 3 lymph nodes are normally palpable?
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Submandibular, axillary and inguinal lymph nodes
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State the symptoms and physical exam findings associated with hyperthyroidism
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•Most common cause is Grave’s disease
•Heat intolerance -diarrhea -Goiter •***thyroid bruit – systolic or “to and fro” bruit seen in 63% of Graves disease •Lid lag→ should not see the white of pt eyes when they look down fast, but in hyperthyroidism you do •Exopthalmos/Proptosis→ bug eyes-think Bart Simpson when strangled •Sweating, strong, rapid pulse •Weight loss •Fine tremor |
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State the symptoms and physical exam findings associated with hypothyroidism
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•Most common autoimmune cause is Hashimoto’s Thyroiditis
•Cold intolerance -weight gain •Slowing of mind and body •Weak heartbeat •Constipation •Slow reflexes •High LDL •Depression, schizo, irritability •Big tongue, croaky voice |
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Generalized lymphadenopathy
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-2 or more noncontiguous (non-connecting) enlarged lymph nodes
-should always prompt clinical investigation |
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Shotty lymph nodes
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are small, round (like “buckshot”) and are usually reactive
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Tender lymph nodes
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-suggests infectious etiology
-ex. step throat |
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Fixed lymph nodes
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consider malignancy
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Matting
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-group of nodes that feel connected (benign TB/Sarcoidosis, malignant- mestastatic cancer or lymphoma
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What size of a lymph node makes it abnormal?
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greater than 1 cm
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discuss the importance of palpation of the thyroid gland for consistency and size.
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•Thyroid should be similar in consistency to muscle tissue
•Normally it is not palpable •Enlargement is termed a goiter and may be graded from 0-2 ➢Grade 0: No goiter ➢Grade 1: Detectable only by palpation ➢Grade 2: Visibly Enlarged and Palpable ➢May be seen in hyperthyroidism, euthyroidism, and hypothyroidism |
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Stenson’s duct
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-Duct of the parotid gland
-Enters the oral cavity through a small papilla opposite the upper first and second molar tooth |
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Wharton’s ducts
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-Duct of the submandibular gland
-Terminates in a papilla on either side of the frenulum at the base of the tongue |
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identify relevant symptoms in the diagnosis of oral cavity disorders.
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-pain
-Ulceration -Bleeding -Mass -Halitosis (bad breath) -Xerostomia (dry mouth) |
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Peutz-Jeghers Syndrome
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- Classic brown pigmentary change on the lips
-Autosomal dominant disorder that is characterized by generalized GI hamartomatous polyposis and mucocutaneous pigementation |
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Rubella
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posterior cervical and occipital lymphadenopathy
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Infectious mononucleosis is classically associated with what?
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-Posterior Cervical lymphadenopathy (In addition to anterior lymphadenopathy)
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What lymph nodes are the most worrisome for malignancy?
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-Supraclavicular lymph nodes
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Right supraclavicular node
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-Drains mediastinum, Lungs, esophagus
-Indicates Lungs, retroperitoneal or GI cancer |
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Left supraclavicular node
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-Drains thorax, abdomen via thoracic duct
-Lymphoma, thoracic or retroperitoneal cancer. Bacterial or fungal infection |
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Troiser's sign
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-The finding of a palpable left supraclavicular lymph node; this is called Virchow's node
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Normal weight of a thyroid?
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20-30 grams
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pemberton sign
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with goiter, Raise arms and face gets flushed. Superior vena cava can be obstructed due to goiter
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Stevens Johnson Syndrome
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-Presents with bullous lesions of the skin and mucous membranes
-Lesions on face, mucosa becomes inflamed -Sulfa drugs, allergic reactions |
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Herpes Stomatitis
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-Cold sores on lips and external nares.
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Angular Cheilitis (Perleche)
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-inflammatory lesion at the labial commissure, or corner of the mouth, and often occurs bilaterally. The condition manifests as deep cracks or splits.
-classically hiv or vit b deficiency |
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Hutchinson’s teeth
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-Seen in congenital syphilis
-Dark spot in the middle of teeth |
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Erythroplakia
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-a reddened patch with a velvety surface found in the mouth
-More likely to be a neoplasm than leukoplakia |
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Leukoplakia
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-a precancerous lesion that develops on the tongue of the inside of the cheek as a response to chronic irritation
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Koplik’s spots
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classic board associated with measles → salt grains on a red beach
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Cobblestone
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seen in post-nasal drip
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Dysphagia
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-difficulty swallowing
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Dysphonia
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-change in voice, customary with laryngeal disease
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Xerostomia
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-dry mouth due to reduced or absent salivary secretions
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Ptyalism
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-excessive production of saliva
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Deglutination
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-The act of swallowing, particularily the swallowing of food
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CN IX and X dysfunction
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Paralysis of soft palate and vocal cords on same side of lesion
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CNXII dysfunction
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Results in tongue deviation to one side. TONGUE DEVIATES TO SIDE OF LESION
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Summarize typical examination features and risk factors for oral cavity carcinomas.
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-Carcinoma of the lib (accounts for 30% of all cancers in the area)
-Risk factors: Smoking, alcohol, spices, syphilis, spikes (ill-fitting dentures), Virsuses (EBV, HPV, HSV), Radiation, Dietary) |
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Chvostek’s sign
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-Examiner taps gently over the facial nerve in front of the ear
-Contraction fo the muscles of the eye mouth or nose, elicited by tapping along the course of the facial nerve -Seen in tetany, hypocalcemia, sometimes anxiety |
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Vermillion border
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– border located on the lip (separates inside from outside lip)
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Halitosis
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-Volatile sulfur compounds (VSCs)
-Originates in the mouth in 85 to 90 % of ambulatory patients |
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Ranula
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mucous retention cyst
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Sialoithiasis
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calculi in the salivary glands (stones)
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Chvostek's sign
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-Examiner taps gently over the facial nerve in front of the ear. Chvostek's sign is contraction of the muscles of the eye. mouth, nose, elicited by tapping along the course of the facial nerve
-Seen in tetany, hypocalcemia and sometimes anxiety |
