Head and Neck

Question 1

order of areas

Answer 1

hair/scalp, face, ears, eyes, throat, neck (lymph nodes, thyroid)

Question 2

What to look for: hair

Answer 2

quality (fine = hyperthyroidism, coarse = hypothyroidism), white ovoid granules (nits), dandruff (seborrheoeic eczema)

Question 3

What to look for: Scalp

Answer 3

redness (seborrheic dermatitis / eczema), redness w plaques (psoriasis), soft lumps (pilar cysts), pigmented nevi (moles, check for signs of melanoma)

Question 4

What to look for: skull

Answer 4

observe general size, inspect any depressions

Question 5

What to look for: face

Answer 5

facial expressions, symmetry (Bell’s palsy), pigmentation (port wine stain), hair distribution (hirsutism - women w PCOS), acne, lesions

Question 6

Cushing Syndrome

Answer 6

moon face, red cheeks, excessive hair growth

Question 7

Nephrotic syndrome

Answer 7

swelling around the exes, pale looking, puffy face

Question 8

Parkinson’s

Answer 8

Hypomania (decreased face mobility, stare)

Question 9

Temporal Arteritis

Answer 9

aka: Giant Cell Arteritis
>60 y.o., females > males, associated w polymyalgia rheumatica

Question 10

Temporal Arteritis S&S

Answer 10

Severe, localised head pain, tenderness over artery, new persistent headache, later: vision loss

Question 11

What to look for: Forehead

Answer 11

sinuses, arteries

Question 12

Sinusitis

Answer 12

polyps, infection (usually viral), allergies, deviated septum

Question 13

What to look for: ear

Answer 13

cerumen, inflammation, foreign bodies, swelling, blood
look at: tympanic membrane, cone of light, malleus, short process of malleus & incus

Question 14

DDX: ear pain (otalgia)

Answer 14

pinna, middle, external and other

Question 15

Pinna pain

Answer 15

perichondritis, cellulitis, neoplasm (basal cell or squamous cell)

Question 16

external ear pain

Answer 16

otitis externa, impacted wax, foreign bodies, herpes zoster

Question 17

middle ear pain

Answer 17

acute otitis media, otitis media with effusion (glued ear), Eustachian tube obstruction

Question 18

other pain around the ear / referred pain

Answer 18

teeth, tongue, pharynx, sinus, TMJ, Cx Spine

Question 19

DDX: ear discharge

Answer 19

external: otitis externa, middle ear: acute supportive otitis media, chronic suppurative otitis media
inner: fracture (CSF leak)

Question 20

Eye examination

Answer 20

inspection, focus on changes to the normal appearance, inspection of the eyebrows, cranial nerves covered in Neuro-ortho

Question 21

What to look for: Eyebrows

Answer 21

equal? hair loss? lateral thinning?
loss -> SLE, lateral thinning -> Hypothyroidism

Question 22

What to look for: Eyes / Eyelids

Answer 22

Ptosis (Horner’s Syndrome, Myasthenia Gravis), Xanthelasma, Exophthalmos, lid retraction (Hyperthyroidism, Grave’s disease)