Ent-Pediatric Neck Masses

Front 1

Slow growth rate of a PNM is probably

Back 1

benign

Front 2

rapid growth of a PNM is probably

Back 2

infective or MUCH less often, malignant

Front 3

The only type of PNM to present with pain is?

Back 3

Infection

Front 4

Flutuant masses can be:

Back 4

infected, un-infected cyst, hemagioma

Front 5

What is the size cutoff for a concerning node

Back 5

> 2 cm

Front 6

what percent of infants have palpable, movable nodes?

Back 6

40%

Front 7

fixed nodes suggest

Back 7

malignancy

Front 8

Hard nodes suggest

Back 8

infection or malignancy

Front 9

1) Most common scan used for PNM?
2) why?

Back 9

1) CT WITH contrast
2) quick and doesnt need sedation

Front 10

What is the CT finding for an abcess?

Back 10

Ring enhancing

Front 11

What can a US study show you about a PNM?

Back 11

cystic vs. solid

Front 12

In which cases would you do a fine needle aspirate of a PNM?

Back 12

very suspicious for malignancy

Front 13

Lab work for PNM (4 things)

Back 13

CBC
EBV
Bartonella (Cat-scratch)
PPD

Front 14

Most common midline PNM?

Back 14

Thyroglossal duct cyst

Front 15

How man pairs of branchial arches are there?

Back 15

6

Front 16

pouches lined by what?

Back 16

endoderm

Front 17

clefts lined by what?

Back 17

ectoderm

Front 18

Each arch consists of?

Back 18

A, N, cartilage

Front 19

Arch with associate nerve
1) first arch
2) second arch
3) third arch
4) arches 4-6

Back 19

1) V
2)VII
3) IX
4) X

Front 20

1) Define a "sinus"
2) define a "fistula"

Back 20

1)has an opening on one end into a body cavity
2) has an opening into a body cavity and onto the skin surface.

Front 21

1) most common branchial cleft cyst?
2) where is it located?

Back 21

1) second branchil cleft syst
2) anterior triangle of the neck

Front 22

Second branchial cleft cyst:
1) pain?
2) fluctuation?
2) location

Back 22

1) NO pain
2) YES fluctuation
3) deep to econd arch, superficil to third arch structures. ANTerior to SCM, superficial to CN IX and X between internal and external carotids

Front 23

What must one remember when resecting a cyst?

Back 23

Take the cyst AND the path it came from

Front 24

1) diagnosis of 2nd branch. arch cyst?
2) treatment?

Back 24

1) CT or MRI
2)surgery

Front 25

thyroid starts between which to arches?

Back 25

1 and 2

Front 26

Thyroglossal duct cyst
1) does what with tongue protrusion?
2) What information do we gather from US or CT workup?

Back 26

1) elevated
2) Confirm that is a cyst and tat there is some normal thyroid tissue present, such that we will not be resecting their only source of hormone

Front 27

Thyroglossal duct cyst:
1) treatment surgery is called what and consists of what?

Back 27

Sistrunk procedure- resection of cyst and middle part of hyoid bone

Front 28

Most midline carcinomas have what origin?

Back 28

thyroid-papilary

Front 29

Dermoid cysts are midline, painless cysts like thyroglossal duct cysts:
1) how do we distiguish from TGDC?
2) contain what embryological layers?
3) Tx?

Back 29

1) Do not elevate with tongue
2) mesoderm and ectoderm
3) surgical excsion

Front 30

Teratoid cysts
1) bigger/smaller masses?
2) present earlier/later in life?
3) embryonic cell layer?
4) Tx?

Back 30

1) bigger
2) earlier
3) all three
4) surgical excision

Front 31

1) Most common cause of pediatric neck masses?

Back 31

Movable neck nodes

Front 32

what percent of infants with palpable neck nodes DO NOT have infection

Back 32

55%

Front 33

Most common cause of infection in peds causeing nodes?

Back 33

virus

Front 34

most common site of palpable nodes in kids?

Back 34

submandibular

Front 35

1) Which is more common cause of PNM, typical or atypical TB?
2) describe mass caused by atypial TB

Back 35

1) atypical
2) violaceous

Front 36

Two Most common infective causes of bacterial infective PNMs?

Back 36

S. Aureus and GAS

Front 37

What do you tell a patient with MONO?

Back 37

stay away from sports

Front 38

Lemierres syndrome
1) what is it?
2) presentation?
2) classic physical finding?

Back 38

1) Septic thrombophlebitis of the Internal Jugular vein
2) spiking fevers and unilateral neck swelling
2) huge visible IJ

Front 39

If you see a conjuctival infection, fever, rash, and red oral cavity, along with cervical lymphadenopathy, what rare infection should you think of?

Back 39

Kawasaki

Front 40

What is the most common tumor of infancy?

Back 40

Hemangioma

Front 41

big red blotch presents in first few months of life, grows rapidly, and then involutes. Dx?

Back 41

Hemangioma

Front 42

Big vascular lesion presents at birth and grows with child forever and causes bone and cartilage destruction. Dx?

Back 42

Vascular malformation

Front 43

What is the rule for the time scale of disappearance of hemangiomas?

Back 43

50% by 5
70% by 7

Front 44

Most common malignancy in children?

Back 44

Lymphoma

Front 45

1) Which kind of lymphoma can present as a neck mass?

2) Tx?

Back 45

1)Hodgkins
2) chemo w/ or w/o rads

Front 46

1) Most common soft tissue sarcoma?
2) 2 peak incidence age groups?
3) Tx?

Back 46

1) Rhabdomyosarcoma
2) 2-5 and 15-19
3) doesnt respond well so needs debulking

Front 47

what is the age range for the presentation of lymphadenitis and thyroglossal duct cyst?
2) For Branchial cyst and lymphoma?

Back 47

1) all ages
2) schoolchild and up

Front 48

cyst that is commonly misdiagnosed as a thyroglossal duct cyst

Back 48

dermoid (meosderm and ectoderm)