ENT Flashcards
Ear pain/otitis media
nosebleeds/ nasal discharge
Cervical LNs
Nasopharyngeal carcinoma
Nasopharyngeal carcinoma - Ix? Mx?
CT/MRI head
Mx = radiotherapy
Neck lump - midline. Ddx?
- Thyroid: moves up and down on swallowing
- Malignancy, adenoma, thyroiditis, Graves - Thyroglossal cyst: moves up on tongue protrusion
Neck lump - anterior triangle. Ddx?
- Congenital = Branchial cyst: does NOT transilluminate.
2. Vascular = CAROTID aneurysm/body tumour
Neck lump - posterior triangle. Ddx?
- Pharyngeal pouch = gurgling, hallitosis
2. Vascular = SUBCLAVIAN artery aneurysm
Formation of a pharyngeal pouch?
Herniation of pharyngeal mucosa through its muscular wall
Neck lump in midline - what two tests can u do o/e to determine Dx?
Swallow Tongue protrusion (rises = thyroglossal cyst)
what is a thyroglossal cyst
Remnant of the thyroglossal duct
What is a branchial cyst
Failure of fusion of 2nd and 3rd brnahical arches
4 Types of malignant thyroid cancers - most common? worst prognosis? neuroendocrine?
Most common = papillary (good prognosis!)
Worst prognosis = anaplastic (rare)
Neuroendocrine = Medullary (Men2a)
Follicular also exists
Assessment of a thyroid lump - which Ix?
Clinical examination
USS
FNAC
Men2
Medullary thyroid cancer
Phaeo
hyperPTH or marfanoid
red flags in neck lumps
Rapid growth Hard/irregular B symptoms Hoarse voice/dysphagia Previous radiotherapy
Pre-op considerations for thyroid surgery
- Laryngoscopy = check integrity of vocal cords
- CXR + CT = retrosternal goitre (surgical diff)
- Render pt EUTHYROID (w b-b or CBZ)
Complications of thyroid surgery
Early: Haematoma Hypocalcemia Infection Rec laryngeal nerve palsy THRYOID STORM Late: Hypothyroidism Keloid scar Recurrence of disease
