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Surgery > Head And Neck, Thyroid > Flashcards

Head And Neck, Thyroid Flashcards

(90 cards)

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1
Q

Form of mucous retention cyst that involves the sublingual gland

A

Ranula

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2
Q

Mucus retention cyst that involves the gingiva among pregnant women and resolves post partum

A

Epulis gravidarum

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3
Q

Painless mass of the jaw associated with an impacted teeth

A

Ameloblastoma (adamantinoma)

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4
Q

Butterfly shaped ulcer involving the hard palate

A

Necrotizing sialometaplasia

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5
Q

Nasopharyngeal carcinoma is treated with

A

Cisplatin

5-FU

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6
Q

Structures preserved in a modified radical neck dissection

A

SCM
Internal jugular
Spinal accessory

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7
Q

Most common type of malignancy arising from a thyroglossal duct cyst

A

Papillary carcinoma

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8
Q

Most common branchial cleft anomaly

A

2nd branchial cleft

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9
Q

Deep neck infection may extend down to the mediastinum through

A

Substernal space of Burns

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10
Q

Most common malignant tumor of the parotid gland

A

Mucoepidermoid carcinoma

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11
Q

Most common malignant tumor of the minor salivary glands

A

Adenoid cystic

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12
Q

Only tumor virtually restricted to the parotid gland

A

Warthin tumor

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13
Q

Residual thyroid tissue left behind during descent

Presents as midline neck mass just below hyoid bone
Moves with protrusion of the tongue

A

Thyroglossal duct cyst

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14
Q

Treatment for thyroglossal duct cyst

A

Sistrunk operation

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15
Q

Result from maldevelopment and obstruction of the lymphatic system
May extend to axilla or mediastinum

Soft nontender mass usually at posterior triangle of the neck

A

Cystic hygroma

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16
Q

Imaging of choice for cystic hygroma

A

MRI

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17
Q

Treatment for cystic hygroma

A

Sclerosing agent- bleomycin, OK 432

Excision- preferred

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18
Q

Benign lesions of the lip are treated with

A

Wide excision and reconstruction

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19
Q

Benign lesion of the oral cavity:

Submucosal accumulation of mucus due to rupture of ductal system

Smooth round with bluish hue

A

Mucous retention cyst

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20
Q

Mucous retention cyst involving sublingual gland

A

Ranula

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21
Q

Treatment for ranula

A

Marsupialization

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22
Q

Granulomatous lesions of the lip that is due to exaggerated inflammatory response

A

Epulis

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23
Q

Rare benign tumor of the tongue
Derived from Schwann cells
Firm submucosal swellings in the mid 1/3 of tongue

A

Granular cell myoblastoma

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24
Q

Highly expansile and destructive fibrovascukar neoplasm of the nose

Typically in adolescent males
Presents with epistaxis that cancbe massive

A

Juvenile nasopharyngeal angiofibroma

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25
What blood vessels are located in the posterior nasal septum, implicated in epistaxis in the elderly?
Woodruff plexus
26
Benign lesion of the larynx that arise from the TRUE vocal cord Presents with hoarseness
Papilloma
27
Benign lesion of the larynx: Herniation of the laryngeal ventricles Related to chronic increases in intralaryngeal pressure
Laryngocele
28
Arise from progenitors of tooth development | Involve maxilla and mandible
Odontogenic tumors
29
Arise from dental lamina Associated with impacted tooth Painless mandibular mass Soap bubble appearance
Ameloblastoma (adamantinoma)
30
Gene mutation involved in head and neck cancer
P53
31
Structures removed in a radical neck dissection
ISIS Levels 1-5 cervical Spinal accessory nerve IJV Sternocleidomastoid
32
MRND removes what structures
Levels 1-5 cervical LN Preserves everything else
33
Supraomohyoid neck dissection is done for which malignancy
Oral
34
Laryngeal malignancies are treated with
Lateral neck dissection
35
Posterolateral neck dissection is used for which malignancy
Thyroid
36
Cancer that presents in the upper lip
BCC
37
Treatment for gingival/tongue cancer if N+
MRND
38
Treatment for tongue cancer with mandibular involvement
Partial glossectomy + floor of the mouth and madibulectomy
39
Presents at advanced stage | Progressive Dysphagia
Cancer of the Hypopharyngeal area
40
Treatment for hypopharyngeal cancer
RT | chemo + RT for T2
41
Cancer that presents with hoarseness, airway compromise and dysphagia
Laryngeal cancer
42
Treatment for supraglottic laryngeal cancer
Early- RT | Advanced- surgery and RT
43
Treatment for subglottic laryngeal cancer
Total laryngectomy plus neck dissection regardless of N status
44
Incidence of malignancy is most often seen in what salivary gland?
Sublingual
45
Malignant features of a salivary gland tumor
Rapid growth Paresthesia Pain Trismus
46
Treatment for parotid gland tumors
Lateral lobe- superficial parotidectomy | Deep- total
47
Weight of thyroid gland
20 grams
48
The thyroid gland is located in between what tracheal rings
2nd-4th
49
Superior and inferior thyroid vein drains into
IJV
50
Inferior thyroid vein drains into
Brachiocephalic vein
51
The carotid sheath contains
Internal carotid vagus nerve Common carotid Internal jugular vein
52
More commonly injured recurrent laryngeal nerve during surgery
Right recurrent
53
All laryngeal muscles are innervated by the recurrent layngeal nerve except
Cricothyroid
54
Cricothyroid is innervated by
Superior laryngeal nerve
55
Antithyroid drug associated with congenital aplasia
Methimazole
56
Absolute contraindications to RAI therapy
Pregnancy | Breastfeeding
57
Requirement before undergoing thyroid surgery
Must be euthyroid
58
Lugol iodine solution is given how many days prior to thyroid surgery to decrease vascularity and lessen risk of thyroid storm
7-10 days
59
Recurrent acute thyroiditis should raise a suspicion for presence of a
Persistent pyriform sinus fistula
60
Viral in origin or post viral inflammatory response 30-40 years old History of preceding URTI Painful type
Subacute thyroiditis | De Quervain's
61
Most common inflammatory disorder of the thyroid gland and leading cause of hypothyroidism Diffuse infiltration of lymphocytes and plasma cells
Hashimoto thyroiditis
62
Thyroiditis associated with autoimmune disorders Painless hard anterior neck mass Compressive symptoms in weeks Hard, woody thyroid gland
Reidel thyroiditis
63
What autoimmune diseases are associated with Reidel thyroiditis
Ulcerative colitis Primary sclerosing cholangitis Retroperitoneal fibrosis
64
Single most important test in evaluation of thyroid nodules
FNAB
65
FNAB cannot diagnose which type of thyroid CA
Follicular and Hurthle cell | -frozen section
66
Ultrasound features suggesting malignancy in a thyroid nodule
``` Hypoechogenicity Microcalcifications Irregular borders Increased nodular blood flow Evidence of tumor invasion or regional LN mets ```
67
Management for colloid adenoma
>3cm: lobectomy + isthmusectomy <3cm: observe or thyroxine
68
Predominant type of thyroid malignancy in children, radiation exposure and iodine sufficient areas Orphan Annie nuclei Psammoma bodies
Papillary carcinoma
69
Most important prognostic factor for thyroid CA
Age
70
Most common spread of papillary carcinoma
Lymph node
71
Most common spread of follicular thyroid CA
Hematogenous
72
Thyroid CA common in iodine deficient areas Cannot be diagnosed by FNAB Capsular and vascular invasion
Follicular
73
Cannot be diagnosed by FNAB More often multifocal and bilateral Higher mortality More likely to metastasize to distsnt sites
Hurthle cell
74
Thyroid CA that arise from para follicular cells Associated with germline mutation at ret proto oncogene ( MEN 2a 2b) Pheochromocytoma Neck mass with cervical lymphadenopathy Chief cell hyperplasia Eleveted calcitonin, CEA
Medullary thyroid
75
In medullary thyroid CA, pheochromocytoma must be treated first with
Phenoxybenzamine
76
Thyroid CA that presents in the 7-8th decade With distant mets at presentation FNAB: giant multinucleated cells Thyroidectomy small advantage
Anaplastic
77
Thyroid CA that arise from Hashimoto
Thyroid lymphoma
78
Treatment for thyroid lymphoma
``` R CHOP Rituximab Cyclophosphamide Doxorubicin Vincristine Prednisone ```
79
Most common malignancy that metastasize to the thyroid gland
Renal Cell CA
80
Inferior parathyroid comes from which branchial pouch
3rd
81
Superior parathyroid comes from which branchial pouch
4th
82
Blood supply of parathyroid usually comes from
Inferior thyroid
83
Most common location of supernumerary glands
Thymus
84
Most common location of ectopic parathyroids
Para esophageal
85
Pentad of primary hyperparathyroidism
``` Kidney stones Painful bones Abdominal groans Psychic moans Fatigue overtones ```
86
Indications for parathyroidectomy if asymptomatic
``` Serum Ca: > 1mg/dl above upper limit Crea clearance reduced by 30% Kidney stones >400mg/d 24 hour urine Ca Decreased bone mineral density Age less than 50 ```
87
3 1/2 parathyroidectomy or total + auto transplantation is the management for
Parathyroid hyperplasia
88
Treatment for parathyroid adenoma
Resection
89
Preoperative localization test for parathyroid glands
Sestamibi scan
90
Secondary hyperparathyroidism occurs in patients with
Chronic renal failure

Surgery (5 decks)

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