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54 Cards in this Set
- Front
- Back
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What must you suspect in adult with a neck mass present for longer than one week?
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cancer
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Why do older patients have a more pronounced sub-mandibular gland?
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due to atrophy of the platsyma muscle
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What are factors that should increase the index of suspicion for a neck mass?
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• dysphagia
• halitosis • hemoptysis • hoarseness of the voice • respiratory distress • weight loss |
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True/False: Fine-needle biopsy can be used to rule-out malignancy
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• Fine-needle biopsy can confirm diagnosis but does not rule-out malignancy
• The correct answer is: False |
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What imaging study should be used to evaulate neoplasms in bone?
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CT scan w/ contrast
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What imaging study should be used to evaluate neoplasms in soft tissue?
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MRI w/ gadolinium
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What are brachial cleft cysts?
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• originate from the failure of pharyngobranchial ducts to obliterate during early development
• present when they become swollen after a cold or URI • characteristically fluctuant in nature and have a cystic feel |
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What is the most common source of brachial cleft cysts?
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second branchial cleft (located just anterior the SCM muscle
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What is the definitive treatment for a brachial cleft cyst?
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surgical removal
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How does a patient with a thyroglossal duct cyst present?
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• midline round soft (sometimes fluctuant) mass at the level of the hyoid bone or below
• mass rise with tongue protrusion |
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What is the treatment for a thyroglossal duct cyst?
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• excision with the tract
• includes removal of the center portion of the hyoid bone (Sistrunk procedure) |
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What is a cystic hygroma? What is the treatment?
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• aka lymphagnioma
• an abnormality in development of regional lymphatics • Tx: Surgical excision of the lympathic tissue |
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What is the most common head and neck neoplasm in children?
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hemangioma
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True/False: Chemotherapy, used alone, is an effective treatment modality for head and neck cancer
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• Chemotherapy alone is not an effective treatment modality and is only used as part of multimodality treatment for advanced lesions
• The correct answer is: False |
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What are the different tests used to evaluate thyroid goiter & nodules?
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• 1st line: ultrasound
• 2nd line: fine-needle aspiration • 3rd line: nuclear scan |
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Which nuclear scan result has a better prognosis, a hot or cold nodule?
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• Cold Nodules may indicate malignancy and have a worse prognosis
• Hot nodules are functioning tissue (better prognosis) |
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Which iodine contrast is diagnostic and which is therapeutic?
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• Diagnostic: I 123
• Therapeutic: I 131 |
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What are the 4 types of thyroid neoplasms?
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• papillary adenocarcinoma (80%)
• follicular carcinoma (20%) • medullary (<10%) • anaplastic (5%) |
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Which thyroid neoplasm is the most aggressive?
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anaplastic
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What are complications of thyroid surgery?
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• transient hypocalcemia
• vocal cord paralysis (due to injury to the recurrent laryngeal nerve) • thyroid deficiency |
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What are 2 signs of hypocalcemia?
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• Chvostek's sign
• Trousseau's sign |
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What are causes of a hoarse voice in children?
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• hemangiomas
• laryngeal web • papilomas • screamers nodules • subglottic stenosis |
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What must be ruled-out in children with a hoarse voice?
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airway compromise
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What are causes of a hoarse voice in an adult?
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• chronic hypertrophic laryngitis
• laryngitis • spastic dysphonia • squamous cell carcinoma |
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What is spastic dysphonia?
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clapping of vocal cords
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What is the treatment for vocal cord nodules?
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speech therapy
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What is the treatment for reflux laryngitis?
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• anti-reflux medications
• diet |
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What is the treatment for acute laryngitis?
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voice hygiene
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What is the treatment for chronic laryngitis?
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• voice rest
• speech therapy |
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What is the treatment for laryngeal carcinoma?
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• radiation therapy
• surgery |
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If a patient has a problem with their left vocal cord, you should suspect a lesion in this area?
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lung
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If the patient has a problem with their right vocal cord, you should suspect a lesion in this area?
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brain
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What is the most common congenital abnormality of the larynx?
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laryngomalacia
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What is the laryngomalacia?
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• immature development results in soft laryngeal walls that close airway
• usually the child outgrows this; no treatmnet necessary |
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What is the most prominent symptom of laryngomalacia?
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inspiratory stridor
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How do you manage a laryngeal hemangioma?
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• most resolve within two years
• may require debulking or interferon |
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What are symptoms of congenital webbing?
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inspiratory and expiratory stridor
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What is the treatment of a congenital web?
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surgical ligation and cauterization (may regrow)
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Why should you not intubate a patient with epiglottis?
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may cause spasm
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What is the treatment for epiglottitis?
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• admit
• IV antibiotics • oxygen |
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What is laryngotracheitis (croup)?
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inflammation of the subglottic larynx/upper trachea
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What are signs and symptoms of croup?
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• recent URI
• barking cough • symptoms worse at night |
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What is the treatment for croup?
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• cool mist
• epinephrine • oxygen |
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What is the treatment for vocal cord carcinoma?
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radiation therapy (90% cure rate)
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What is the most common cause of vocal cord polyps?
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secondary to endotracheal intubation
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What is the general incidence of malignancy of a salivary neoplasm of the parotid gland? submandibular gland? sublingual gland?
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• parotid gland (25%)
• submandibular gland (50%) • sublingual (75%) |
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What is the treatment for a pleomorphic adenoma?
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surgical removal
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What is the treatment for a Wharthin's tumor?
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surgical removal
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What is sialadenitis?
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inflammation of the salivary ducts from non-specific bacterial infection or blocked excretory ducts
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What is the most commonly affected gland with invasion of bacteria from the oral cavity?
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parotid
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What is the treatment for parotitis?
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• antibiotics
• dilation stenson's duct • Sialogogues • increased hydration |
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What is the treatment for sialoadenitis?
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• antibiotics
• dilation stenson's duct • Sialogogues • increased hydration |
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Sialolithiasis are more commonly associated with which glands?
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submaxillary glands
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What is the treatment for sialolithiasis?
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marsupilization
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