Lecture 7- Integrated cases (retrieve and refresh)

Question 1

if someone presents to GP with a lump what information from the persons hisotry and exm would help you determine the lump?

Answer 1

History features

• When did she notice it
• Where is it?
• Painful?
• Onset? Sudden or gradual?
• Recent infections
• Other health conditions
• History of cancer
• Ulcer
• Red flags

Examination features

• Is it central ?
  
  • Goitre
  • Thyroglossal cysts
  • Dermoid cysts
• Is it Lateral ?
  
  • Submandibular gland pathologies
  • Branchial cyst
• Does it move on swallowing?
• Fixed or loose
• Look for oedema
• Check mouth for ulcers
• Palpate draining lymph nodes
• Skin changes – signs of inflamm e.g. branchial cyst

Question 2

• Red flags

Answer 2

• Fast growing
• Hard
• Night sweats
• Weight loss
• Thick
• fatigue

Question 3

if the lump is painful, changes slighly in size. particularly painful before meal?

Answer 3

• Infected salivary gland caliculi
• Cancer?
  
  • Would probs also be bleeding

Question 4

Answer 4

• A- tonsilitis
  
  • Jugulodigastric lymph node may be palpable because palatine tonsils drain into here

Question 5

an intracranail haemorrhage is suspected. What type of intrcranail haemorrrhage is most likely?

Answer 5

• A- extradural
  
  • Lucid interval characteristic of extradural haemorrhage
  • when someone passes out, wakes and seems lucid and then deteriorate very quickly
  • Headache
  • After head injury

Question 6

most liekly source of extradural bleeding after bike accident

Answer 6

• middle meningeal artery
  
  • Haemorrhage looks white on CT scan (remember imagine looking up from feet)

Question 7

*

Answer 7

• Atrial fibrillation
  
  • Wavy baseline, irregular, no p Wave
  • Can cause TIA- due to sequestered blood due to lack of force on blood leaving heart- blood clots form

Question 9

Answer 9

Internal carotid artery (no branch)- which will supply the opthalmic artery