Head and Neck

Question 1

resolution of aphthous ulcers

Answer 1

spontaneously in 7-10 days

Question 2

clinical forms of candidiasis

Answer 2

pseudomembranous aka thrush
hyperplastic
erythematous

Question 3

hairy leukoplakia

Answer 3

lateral border
cannot be scraped off
associated with EBV

Question 4

cause of precancerous lesions

Answer 4

tobacco

Question 5

most common lesion of head and neck

Answer 5

squamous cell carcinoma

Question 6

HPV associated with sinonasal papilloma

Answer 6

6 and 11

Question 7

virus nasopharyngeal carcinoma

Answer 7

EBV

Question 8

presentation nasopharyngeal carcinoma

Answer 8

nasal obstruction and epistaxis

Question 9

ostosclerosis

Answer 9

bilateral hearing loss

abnormal middle ear bone deposition

Question 10

treatment of most head and neck neoplasms

Answer 10

excision

Question 11

paraganglioma

Answer 11

clusters of neuroendocrine cells

Question 12

components of pleomorphic adenoma

Answer 12

mixed-epithelial and myoepithelial

benign and painless tumor

Question 13

location of warthin tumor

Answer 13

restricted to parotid gland

Question 14

mucoepidermoid carcinoma

Answer 14

most common malignant tumor

t(11;19)(q21;p13)

Question 15

adenoid cystic carcinoma

Answer 15

perineural invasion
PAINFUL MASS
parotid and submandibular glands

Question 16

location of thyroglossal duct cyst

Answer 16

most common

midline

Question 17

course of thyroglossal duct cyst

Answer 17

asymptomatic until infected
painless midline swelling
moves with swallowing or sticking out tongue
can be associated with ectopic thyroid

Question 18

embryology causing thyroglossal duct cyst

Answer 18

connects thyroid and foramen cecum
at 5th week fragments, mesoderm condenses into hyoid bone
atrophies by end of 8th week

Question 19

characteristics of thyroglossal duct cyst

Answer 19

epithelial lined cyst
from failure of normal obliteration
infrahyoid most common

Question 20

imaging of thyroglossal duct cyst

Answer 20

ultrasound to diagnose
CT may be used
treat with surgical resection

Question 21

origin of dermoid

Answer 21

outer layers of skin do not properly grow together

lined with epithelium, contains hair, sebaceous glands, sweat glands

Question 22

characteristics of dermoid

Answer 22

moves independently with skin

doughy

Question 23

origin of branchial cleft cyst

Answer 23

remnants of embryonic development from failure of obliteration of one of the branchial clefts
epithelial lined cyst

Question 24

location branchial cleft cyst

Answer 24

lateral neck

Question 25

cyst

Answer 25

no external or internal opening

Question 26

sinus

Answer 26

internal or external opening

Question 27

fistula

Answer 27

both internal and external openings

Question 28

first branchial cleft cyst

Answer 28

type 2 more common type 1 duplication of auditory canal type 2 at angle of mandible

Question 29

most common branchial cleft cyst

Answer 29

second

Question 30

characteristics of second branchial cleft cyst

Answer 30

inferior to mandible and anterior to SCM sinus or fistula tract can extend to ipsi tonsil

Question 31

third branchial cleft cyst

Answer 31

anterior to SCM lower in neck end in pharynx at thyrohyoid member often presents with lower neck infection L>R

Question 32

characteristics of cystic hygroma

Answer 32

lymphatic malformation | multi-loculated lesion in left posterior triangle

Question 33

presentation of cystic hygroma

Answer 33

soft, painless, doughy mass may transilluminate evaluate for tracheal deviation or evidence of impending airway obstruction

Question 34

hemangiomas

Answer 34

usually not present at birth | bright red macule or papule rash with clear boundaries

Question 35

liver MRI and hemangiomas

Answer 35

if 5 or more cutaneous

Question 36

proliferative phase of hemangiomas

Answer 36

continues for up to 15 to 18 months reach 85% of size by 5 months of age may ulcerate

Question 37

involutional phase of hemangiomas

Answer 37

superficial lesions change to dull red, then gray flatten and soften most complete by 10 yo

Question 38

subglottic hemangioma

Answer 38

high risk with segmental beard distribution-preauricular, chin, lower lip, neck biphasic stridor initially diagnosed as croup

Question 39

hemangiomas on MRI

Answer 39

gadolinium MRI study of choice well circumscribed, lobulated mass salt and pepper pattern dilated vessels

Question 40

indications to intervene for hemangiomas

Answer 40

``` accelerated growth hemorrhage infection ulceration problems breathing, swallowing high output CHF ```

Question 41

pharmacological treatment of hemangiomas

Answer 41

propranolol

Question 42

congenital torticollis

Answer 42

SCM is tight and shortened usually discovered in first 6-8 weeks of life injury causes scarring that leaves it tight associated with hip dysplasia

Question 43

presentation torticollis

Answer 43

tilted in a laterally, bending toward affected muscle | rotate to opposite side

Question 44

concerning lymphadenopathy

Answer 44

``` generalized occipital, auricular, supraclavicular, mediastinal, epitrochlear, posterior cervical nodes firm matted nontender >2cm systemic symptoms ```

Question 45

biopsy LN

Answer 45

supraclavicular | 2-6 weeks, >3cm, not responding to antibiotics or risk factors for malignancy

Question 46

common cause of lymphadenopathy

Answer 46

viral most common

Question 47

MAI lymphadenopathy

Answer 47

submandibular common firm, painless mass that does not respond to antibiotics may enlarge and become fluctuant violaceous hue

Question 48

treatment MAI

Answer 48

macrolides-azithromycin also rifampin, ethambutol, aminoglycosides, or fluroquinolones treated with 3 antimicrobials for 12 months excision but not incision and drainage

Question 49

cat scratch disease

Answer 49

bartonella primary inoculation at lesion self limited 6-12 weeks treat with doxy, erythro, azithro

Question 50

Kawasaki disease

Answer 50

``` fever >5 days cervical lymphadenopathy edema/eryhtema palms and soles conjunctivitis strawberry tongue ```

Question 51

most common neoplasm causing lymphadenopathy in children

Answer 51

lymphoma

Question 52

lymphoma

Answer 52

painless neck mass hodgkin in adolescents; non-hodgkin in 2-12 yo M>F hodgkin from EBV

Question 53

concern for lymphoma

Answer 53

>3cm and firm multiple regions supraclavicular or posterior triangle location

Question 54

rhabdomyosarcoma

Answer 54

arise from soft tissue-skeletal muscle

Question 55

embryonal rhabdomyosarcoma

Answer 55

head and neck or GU

Question 56

alveolar rhabdomyosarcoma

Answer 56

arms, legs, chest, abdomen, genital organs or anal area

Question 57

anaplastic rhabdomyosarcoma

Answer 57

rare in children

Question 58

presentation rhabdomyosarcoma

Answer 58

depend on location | commonly a lump or swelling that keeps getting bigger