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Flashcards in Head and Neck Deck (76):
1

most common preventable risk factor in the head and neck CA

tobacco and alcohol

2

It is a second tumor detected within 6 months of the diagnosis of the initial primary lesion

synchronous neopllasm

3

It is a second tumor detected more than 6 months of the diagnosis of the initial primary lesion

metachronous neoplasm

4

What is the initial evaluation of patients with primary CA of head and neck

panendoscopy

5

Most common location of squamous cell CA of the lip

lower lip

6

What nerve is involved when there is paresthesia of the lips

mental nerve

7

treatment of squamous cell cancer of the lip

T1 - T2: resection = radiation
T3 - T4: surgical excision with histologic confirmation of tumor free margin and post operative radiation

8

What are the indications for supraomohyoid neck dissection

1. tumor greater than 4 cm
2. desmoplastic tumor
3. perineural invasion

9

Tongue cancer with lingual nerve involvement causes

ipsilateral paresthesia

10

Tongue cancer with hypoglossal nerve involvement causes

deviation of tongue on protrussion and fasciculations

11

Most common location of tongue cancer

lateral and ventral surfaces

12

Treatment of tongue cancer

T1 - T2 - wide local excision
Base of Tongue - partial glossectomy with supraomohyoid dissection (N0) or MRND (N+)

13

Featurs of plummer vinson syndrome

1. cervical dysphagia
2. IDA
3. atrophic oral mucosa
4. brittle spoon finger nails

14

Treatment of tumor of alveolus and gingiva

1. minimal bone invasion - mandibular resection
2. medullary cavitiy invasion - segmental mandibulectomy

15

Treatment of tumors of nasopharynx

chemotherapy

16

Most common nasophryngeal malignancy in the pedatric age group

lymphoma

17

Lymphatic spread of nasopharynx

1. bilateral regional
2. posterior triangle (level 5)

18

Lymphatic spread of oropharynx

1. upper and lower cervical lymphatics (level 2, 3, 4)
2. retropharyngeal spread

19

Lymphatic spread of hypopharynx

1. bilateral regional
2. mid and lower cervical lymphatics (level 3, 4)

20

Tumors of the oropharynx are radiosensitive

Tumors of the oropharynx are radiosensitive

21

Where does larngeal granuloma usually occur?

posterior larynx on the arytenoid mucosa

22

Most common cause of vocal cord paralysis

iatrogenic

23

Treatment of early stage glottic and supraglottic cancer

Radiation therapy

24

Treatment of small glottic cancer

partial laryngectomy

25

Treatment of supraglottic cancer without arytenoid or vocal cord extension

supraglottic laryngectomy

26

Treatment of advanced laryngeal tumor with extension

total laryngectomy with post op RT

27

Treatment of subglottic cancer

total laryngectomy

28

Pattern of spread from primary tumor of oral cavity and lip

I, II, III

29

Pattern of spread from primary tumor of oropharynx, hypopharynx and larynx

II, III, IV

30

Pattern of spread from primary tumor of nasopharynx and thyroid

V

31

Pattern of spread from primary tumor of nasopharynx, soft palate, and lateral and posterior walls of the oropharynx and hypopharynx

Retropharyngeal lymph nodes

32

Pattern of spread from primary tumor of hypopharynx, cervical esophagus and thyroid

VII

33

Pattern of spread from advanced tumor of glottis with subglottic spread

delphian node

34

What is a radical neck dissection or CRILE method

1. removal of level I to V lymph nodes
2. SCM
3. IJV
4. Spinal accesory nerve

35

What is a modified radical neck dissections

1. removal of level I to V lymph node

36

What is a supraomohyoid neck dissection

1. removal of level I to III
2. oral cavity malignancy

37

What is a lateral neck dissection

1. removal of level II to IV
2. laryngeal malignancy

38

What is a posterolateral neck dissection

1. removal of II to V
2. thyroid cancer

39

What is the procedure of choice for thyroglossal duct cyst

Sistrunk procedure
1. removal of cyst, tract, and central portion of hyoid bone
2. removal of portion of the tongue base up to the foramen cecum

40

Most common gland involved in salivary gland tumor

parotid gland

41

most common benign tumor of salivary gland

pleomorphic adenoma

42

most common malignant tumor of salivary gland

mucoepidermoid carcinoma

43

Most frequently injured nerve in parotid surgery

greater auricular nerve
- will produce numbness of the lower portion of the auricle and periauricular skin

44

The syndrome when the auriculotemporal nerve is injured

Frey's syndrome - postoperative gustatory sweating

45

What are the nerves at risk in submandibular gland removal

lingual and hypoglossal nerve

46

What crosses the recurrent laryngeal nerve

inferior thyroid artery

47

What innervates the cricothyroid muscle

external laryngeal nerve

of the superior laryngeal nerve of the vagus nerve

48

What is a sensitive marker for medullary thyroid cancer

Serum calcitonin

N: 0 - 4 pg/ml

49

Treatment of lingual thyroid

1. exogenous oral thyroid hormone
2. RAI
3. hormone replacement

50

Most common GI symptom of grave's disease

diarrhea

51

Absolute contraindication of RAI

1. pregnant
2. breastfeeding

52

Relative contraindication of RAI

1. young people
2. thyroid nodule
3. ophthalmopathy

53

Treatment of toxic multinodular goiter

subtotal thyroidectomy

54

Treatment of plummer disease

lobectomy and isthmusectomy

-also known as toxic adenoma

55

This is a self limiting PAINFUL thyroiditis usually occurs in 30 - 40 y.o women

Subacute Thyroiditis
De quervain's thyroiditis

56

Treatment of de quervain's thyroiditis

NSAID

since it is self limiting

57

This thyroid disease has a strong association with HLA B35 haplotype

Subacute Thyroiditis
De quervain's thyroiditis

58

The most common presentation of this thyroid disease is minimally or moderately enlarged firm granular gland or the awareness of painless anterior neck mass

Hashimoto's thyroiditis
Chronic Thyroiditis

59

What is seen in microscopic examination of hashimoto's thyroiditis?

Hurthle cell or Askanazy cell

60

This thyroid disease is characterized by replacement of all or part of the thyroid tissue parenchyma by fibrous tissue

Reidel's thyroiditis

61

Physical examination reveals a hard woody thyroid gland with fixation to surrounding tissues

Reidel's thyroiditis

62

What is the first diagnostice test in a solitary thyroid nodule

FNAB

63

Most common site of metastasis in papillary thyroid CA

Lungs

64

What is the type of spread in papillary thyroid CA

lymphatics

65

What is the most important prognostic factor in determining long term survival of papillary CA

age

66

Treatment of papillary CA

1. < 1.5 cm - lobectomy + isthmusectomy
2. multicentric - near total or total thyroidectomy
3. with cervical lymph node - MDRD

67

Most common route of spread of follicular CA

Hematogenous

68

More common cancer in iodine deficient countries

follicular cancer

69

Most common site of metastasis in follicular thyroid CA

lung and bone

70

Treatment of follicular CA

1. Follicular lesion - lobectomy + isthmusectomy
2. Follicular lesion > 4 cm - total thyroidectomy
3. Thyroid cancer - total thyroidectomy
4. Positive lymph node - MDRD

71

Usual site of medullary thyroid cancer

superolateral in the thyroid lobes

72

Where does medullary thyroid cancer arise from

parafollicular cells
C cells

73

Disease associated with men 2A

1, pheochromocytoma
2. parathyroid hyperplasia

74

Disease associated with men 2B

1. pheochromocytoma
2. neuroma

75

Treatment of MTC

Total thyroidectomy with bilateral central node dissection

76

Most common site of minor salivary gland tumor

junction of hard and soft palate