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EENT/ID > Neck Masses > Flashcards

Neck Masses Flashcards

1
Q

Describe the etiology & risk factors of a branchial cleft cyst

A
  • MC congenital neck mass in kids
  • 2-3% bilateral, clusters
  • unknown embryonic changes during gestation
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2
Q

Describe the clinical presentation of a branchial cleft cyst

A
  • fluctuant fluid filled sac of epithelial cells and lymph cells anterior to the SCM
  • can present with URI sxs
  • can develop fistula to skin/sinus
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3
Q

Describe the treatment for branchial cleft cyst

A

refer to ENT for surgical excision (can lead to infection)

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4
Q

Describe the etiology/risk factors for thyroglossal duct cysts

A
  • midline anterior neck mass from leftover thyroid cells
  • usually in childhood prior to 10 y/o
  • embryonic remnant from failure of thyroglossal duct closure
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5
Q

Describe the clinical presentation of thyroglossal duct cysts

A
  • can be asymptomatic
  • dysphagia if enlarged or infected
  • may go undiagnosed until ill
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6
Q

Describe the treatment for thyroglossal duct cysts

A

refer to ENT for surgical removal (1-2% can have carcinoma)

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7
Q

Describe the etiology/risk factors for viral adenopathy

A
  • most common cause of neck masses in peds
  • adenovirus, rhinovirus, enterovirus, influenza, HSV, CMV, EBV
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8
Q

Describe the clinical presentation of viral adenopathy

A
  • bilateral, tender, soft/rubbery submandibular lymph node groups
  • 1-1.5cm in size
  • sometimes constitutional sxs, myalgia, diarrhea, conjunctivitis, oral sores, rash, h/a, otalgia
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9
Q

Describe the treatment for viral adenopathy

A

treat symptoms

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10
Q

Describe the etiology/risk factors for bacterial lymphadenopathy

A
  • usually suppurative LAD from skin/pharynx
  • staph aureus, GABHS most common, MRSA if recent hosp, anaerobic from dental procedure, mycobacterium from soil/water
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11
Q

Describe the clinical presentation of bacterial lymphadenopathy

A

bilateral tender soft/rubbery submandibular lymph node groups

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12
Q

Describe the diagnostic testing for bacterial lymphadenopathy

A

WBC, CRP, procalc, BC, rapid strep test

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13
Q

Describe the etiology/risk factors for parotitis

A
  • inflammation of parotid gland
  • bacterial (staph or anaerobe) or viral
  • secondary to new anticholinergic med, post op, dehydration, poor dental hygiene
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14
Q

Describe the clinical presentation of parotitis

A
  • sialadentitis: inflammation of salivary gland
  • firm, swollen, tender, parotid gland
  • f/s/c
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15
Q

Describe the diagnostic testing for parotitis

A

amylase, WBC, PCR, +/- CT

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16
Q

Describe the treatment for parotitis

A
  • inpt for severely ill pts with IV abx
  • OP with oral abx (clindamycin + ciprofloxacin)
  • hydration, massage, sialogogues, peridex
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17
Q

Describe the etiology/risk factors for sarcoidosis

A

autoimmune, tiny clusters of inflammatory cell granulomas collecting in the lungs, nodes, eyes, skin
- overreaction to resp tract exposure
- 20-40, F>M

18
Q

Describe the clinical presentation of sarcoidosis

A
  • hard palpable lymph node, usually in posterior triangle or supraclavicular space
  • long term prodrome usually accompanying (fatigue)
19
Q

Describe the diagnostic testing for sarcoidosis

A
  • ACE levels and CRP elevated
  • CT neck/chest, EBUS biopsy, skin biopsy
20
Q

Describe the treatment for sarcoidosis

A

refer to pulm for long term care
- prednisone, immunosuppressants, observation

21
Q

Describe the etiology/risk factors for thyroid masses

A

anterior neck mass/goiter (inflammation of thyroid)
- nodules, hard thyroid mass

22
Q

Describe the clinical presentation of thyroid masses

A

goiter, hard nodules in thyroid, asymptomatic or symptoms related to TSH

23
Q

Describe the diagnostic testing for thyroid masses

A

TSH, T3, T4, thyroid ultrasound

24
Q

Describe the treatment for thyroid masses

A

fine needle aspiration if indicated

annual ultrasounds (5% are cancerous)

25
Q

Describe the etiology/risk factors for salivary gland neoplasms

A
  • 80% parotid gland, 20% submandibular or lingual glands
  • 80% benign, 20% malignant
26
Q

Describe the clinical presentation of salivary gland neoplasms

A
  • usually benign asymptomatic growing masses
  • malignancy causes pain, skin changes, affects cranial nerves
27
Q

Describe the diagnostic testing and treatment for salivary gland neoplasms

A
  • CT, FNA
  • refer to onc/surgery
28
Q

Describe the etiology/risk factors for parangangliomas

A
  • vascular tumors occurring anywhere from sympathetic or parasympathetic nerves
  • carotid body tumor most common
  • 75% sporadic
29
Q

Describe the clinical presentation of parangangliomas

A
  • pulsatile mass felt and bruit heard
  • Fontaine’s sign: move horizontally but not vertically
30
Q

Describe the diagnostic testing and treatment for paragangliomas

A
  • MRI/MRA
  • surgical removal
31
Q

Describe the etiology/risk factors for Schwannoma

A
  • tumor on any peripheral nerve
  • usually the vagus nerve or cervical sympathetic chain
32
Q

Describe the clinical presentation of paragangliomas

A
  • slow growing mass in neck
  • hoarseness, aspiration, Horner’s syndrome
33
Q

Describe the diagnostic testing and treatment of Schwannomas

A
  • MRI/MRA
  • surgical removal
34
Q

Describe the etiology/risk factors of lymphomas

A
  • malignancy of lymphocytes (T, B, NK)
  • aggressive non-hodgkins (Burkitts) more common than Hodgkins in kids
  • indolent lymphomas more common than aggressive NHL and HL
  • RF: immunodeficiency, EBV, fam hx, pesticide exposure
35
Q

Describe the clinical presentation of non-hodgkin lymphoma

A
  • f/s/c
  • weight loss
  • itching
  • fatigue
  • malaise
  • oncologic emergency
36
Q

Describe the clinical presentation of hodgkin’s lymphoma

A
  • 70% mediastinal mass
  • f/s/c
  • malaise
  • fatigue
  • chest pain
  • rubbery painless lymph nodes in cervical/supraclavicular space
37
Q

Describe the diagnostic testing for lymphomas

A
  • CT neck, FNA, core biopsy
  • CBC, procalcitonin, throat culture, ESR/CRP, PCR, HIV, TB
38
Q

Describe the diagnostic tests for non-hodgkin’s lymphoma

A

elevated LDH, uric acid, lactic acid

39
Q

Describe the diagnostic tests for hodgkin’s lymphoma

A

reed sternberg cells seen on pathology

40
Q

Describe the treatment of lymphoma

A

refer to oncology for chemo/radiation, surgical excision

EENT/ID (15 decks)

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