Neck lumps.txt

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Author:
nehashah88
ID:
89319
Filename:
Neck lumps.txt
Updated:
2011-06-05 17:34:20
Tags:
neck lumps
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Description:
lymph, infective and other
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  1. What can a lump in the neck be?
    • LYMPH NODES
    • GLANDS
    • GRANULOMATOUS DISEASE
    • NEOPLASTIC
    • OTHER DISCRETE LUMPS IN NECK
  2. What �other� lumps could it be, if not lymph node or salivary?
    • Branchial Cyst
    • Skin cyst
    • Soft Tissue Neoplasms
  3. What is a Branchial cyst?
    • At angle of mandible,
    • Histo - lymphoepithelial cyst,
    • developmental remnant
    • Surgical removal
    • complication Branchial fistula?
  4. How can a dermoid cyst present?
    • can be I/O or E/O
    • Doughy/fluctuant swelling
    • FOM / midline of neck
    • Double chin
    • displaces tongue (interferes with speech/swallow)
    • Surgical removal
  5. Why is the deep cervical chain of nodes important?
    all head and neck lymphatic eventually drain into deep cervical nodes.
  6. What lymph nodes make up the cervical chain, along which vein do they run?
    • Internal jugular vein
    • most superior - jugulodigastric (tonsils)
    • Jugulomyohyoid node - drainage from tongue
  7. What does Submandibular lymph node receive drainage from?
    • gingivae
    • teeth
    • tongue
    • structures along path of facial artery
  8. What does the submental lymph node receive drainage from?
    • lower lip,
    • FOM
    • tip of tongue
    • lower incisor teeth
  9. What consistency is a node assoc with inflammatory process (most likely due to infection)?
    • Soft
    • tender
    • inflamed
  10. Suggest general INFECTIVE causes of lymphad:
    • Oral or local infection (dental, ENT)
    • Upper respiratory tract infection (viruses)
    • systemic infection (e.g HIV, CMV, EBV)
    • Bacterial
    • Viral
    • Fungal
    • Protozoa
  11. Suggest 6 viral causes of lymphadenopathy:
    • HIV (PGL)
    • Mumps
    • EBV
    • Herpes simplex
    • Varicella zoster
    • Measles
  12. Suggest Bacterial causes of lymphadenopathy:
    • Local infections of head and neck
    • TB
    • Syphilis
    • Cat scratch fever
  13. Suggest a Protozoal cause of lymphadenopathy:
    Toxoplasmosis
  14. Suggest a Fungal cause of lymphadenopathy:
    Histoplasmosis
  15. Tx for cat scratch and toxoplasmosis?
    • Both self limiting.
    • Long term tetracycline
  16. What are possible NEOPLASTIC causes of neck lumps?
    • Oro-pharyngeal Squamous Cell Carcinoma
    • Lymphoma
    • Leukaemia
    • Metastases
  17. Granulomatous cause of cervical lymphadenopathy?
    • Sarcoidosis
    • Pulmonary lesions most common
    • cough / dyspnoea
    • Bilateral hilar lymphadenopathy
  18. Oral symptoms of sarcoidosis?
    • Lip swelling,
    • cobblestone mucosa
    • Ulcers or focal swellings
    • Hyperplastic gingivitis
    • Salivary swellings/ dry eyes / dry mouth (SS-like)
  19. In combo with uveitis, facial palsy, pyrexia and parotitis, sarcoidosis?
    Heerfordts syndrome
  20. General principles of managing neck lumps?
    • History
    • Examination
    • Special investigations
    • ----Haematology and serology
    • ----Microbiology
    • ----Ultrasound +/- fine needle aspiration biopsy +/- core
    • ----MRI
    • Open biopsy � EUA
    • Neck dissection

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