Lumps

Question 1

Dercums disease

Answer 1

Multiple painful lipomas
Associated with peripheral neuropathy
Obese post menopausal women

Question 2

Detention of an sebaceous cyst

Answer 2

Epithelial cyst containing keratin

Question 3

Histological subtypes of sebaceous cyst

Answer 3

Epidermial cysts: arise from hair follicle infundibulium

Trichilemmal cyst: arise from hair follicle epithelium

Question 4

Complication of sebaceous cysts

Answer 4

Infection
Ulceration
Calcification

Question 5

Definition of a ganglion

Answer 5

Cystic swelling related to a synovial lined structure

Question 6

Definition of a neurofibromas

Answer 6

Benign nerve sheath tumour arising from Schwann cells

Question 7

Definition of a papilloma

Answer 7

Overgrowth of all layers of the skin with a central vascular core

Question 8

Definition of a dermoid cyst

Answer 8

Epidermal lined cyst deep to the skin

Question 9

Location of dermoid cysts

Answer 9

Midline of nose and neck

Medial and lateral end of the eyebrow

Question 10

Cause of goitre

Answer 10

Diffuse enlargement
- smooth: simple colloid goitre, graves, thyroiditis
- nodular: multi nodular goitre, multiple adenoma
Solitary nodule
- dominant nodule of multinodular goitre
- adenoma
- malignancy: papillary, follicular, medullary, anaplastic
-cyst

Question 11

Indication for thyroid surgery

Answer 11

Mechanical obstruction 
Malignancy 
Marred beauty - cosmesis 
Medial treatment failure 
Mediastinal extension

Question 12

Complication of thyroid surgery

Answer 12

During:
- damage to laryngeal nerve -> hoarse voice
- damage to parathyroid -> hypocalcaemia
Early
- haematoma formation
- infection
- thyroid storm
- laryngeal oedema
Late
- hypothyroidism
- recurrent hyperthyroidism
- scar formation (hypertrophic/keloid)

Question 13

Features of MEN1 - also called Wermer syndrome

Answer 13

Pituitary adenoma
Parathyroid hyperplasia or adenoma
Pancreas endocrine tumour

Question 14

Features of MEN 2

Answer 14

Medullary thyroid cancer
Phaechromoctyoma
A: hyperparathyroidism
B : marfanoid habitus

Question 15

Borders of the anterior triangle

Answer 15

Ramus of the mandible
Midline Anterior margin of sternicliodmastoid
Roof: inverting fascia
Floor: pre-vertebral fascia

Question 16

Operation for management of a thyroglossal cyst

Answer 16

Sistrunk operation

Question 17

Branchial cyst

Answer 17

Failed fusion of 2nd and 3rd bronchial ateries

Contains glary fluid with cholesterol crystals

Question 18

Posterior neck triangle borders

Answer 18

Posterior margin of SCM
Middle 1/3 of clavicle
Anterior margin of trapezius

Question 19

Complications of salivary gland surgery

Answer 19

Immediate
 - facial nerve injury
 - reactionary haemorrhage
Early
- temporary facial weakness:  neuropraxia
- salivary fistula 
- loss of pinna sensation
- greater auricualr nerve damage 
Late : Frey syndrome - gustatory sweating

Question 20

Definition of a lipoma

Answer 20

Benign tumour of mature adipocytes

Question 21

Where does breast cancer spread too

Answer 21

Bones
Lung
Liver
Brain

Question 22

Breast cancer screening

Answer 22

Every 3 years 50-70
- although aiming to extending to 47-73 
Mammography
 If brac then screen from 30 
p53 - 20 yrs 
High risk - 40

Question 23

Risk factors for breast cancer

Answer 23

Early menopause
Late menarche 
HRT 
OCP
first child > 35yrs

Question 24

Compments of triples assessment

Answer 24

History and clinical assessment
Radiology
Pathology - most commonly FNA

Question 25

Surgical complication of breast surgery

Answer 25

Heamatoma, seroma Frozen shoulder Long thoracic nerve palsy Lymphodema

Question 26

Breast cancer prognosis

Answer 26

Nottingham prognostic indicatior - predict survival and risk of relax - 0.2*tumour size + histo grade + nodal status

Question 27

Staging and prognosis of melanocytes

Answer 27

Berlows depth - thickest of tumour - most important prognostic investigators Clark staging - Stratfies depth by 5 anatomical levels

Question 28

Definition of a pressure sore

Answer 28

Localised injury to the skin or underlying tissue over a bony prominence as a result of pressure or sheer forces

Question 29

Categories of pressure ulcer

Answer 29

1. Non blanchable erythema 2. Partial thickeners 3. Full thickness skin loss 4. Full thickness tissue loss - exposed tendon or muscle

Question 30

Definition of cholestetoma

Answer 30

Locally destructive expansion of stratified squamous epithelium within the middle ear or in other area of pneumatised area of the temporal bone

Question 31

Duct ectasia

Answer 31

tender lump around the areola +/- a green nipple discharge

Question 32

Duct papilloma

Answer 32

Local areas of epithelial proliferation in large mammary ducts with blood stained discharge