Lumps and Bumps

Question 1

List 4 generic causes of lumps in the body

Answer 1

1. Lipoma
2. Sebaceous Cyst
3. Lymph Node
4. SkinL Lesions

Question 2

What is Gardener Syndrome?

Answer 2

Autosomal dominant condition characterised by:

adenomatous polyps of the GIT
desmoid tumours
osteomas
epidermoid cysts
lipomas
dental abnormalities
periampullary carcinomas

Question 3

What is the mutation and affected chromosome in Gardener syndrome

Answer 3

Autosomal dominant familial polyposis coli gene on chromosome 5

Question 4

What is Dercum’s Disease? (Adiposis dolorosa)

Answer 4

A rare condition characterized by generalized obesity and fatty tumours in the adipose tissue

Tumours are normally painful and found in multiples

Question 5

Treatment of lipomas

Answer 5

Surgical removal if:

• they’re causing problems ie pain
• if there’s uncertainty about whether it’s a lipoma
• affecting self-esteem

If large…..general anaesthetic

Question 6

Sebaceous (Epidermoid) cysts are a term used to describe what two things?

Answer 6

1. Epidermoid cysts
2. Pilar cysts

Question 7

What is contained within Epidermoid and Pilar cysts?

Answer 7

Keratin

Question 8

Compare the origination of an Epidermoid vs Pilar cyst

Answer 8

Epidermoid cysts originate in the epidermis

Pilar cysts originate from hair follicles

Question 9

Treatment of Epidermoid and Pilar cysts

Answer 9

Leave alone if small and not bothering patient

Excise (LA) if catching on clothes, unsightly location and to avoid infection

Question 10

What are Ganglia?

What is contained within?

Answer 10

Out-pouching of a weakened portion of a joint capsule or tendon sheath

The fluid contained is similar in composion to synovial fluid

Question 11

Common location where ganglia form

Answer 11

Along the extensor carpi radialis brevis as it passes over the dorsum of the wrist joint

Question 12

Treatment of ganglia

Answer 12

1. Leave the cyst in place
2. Aspirate the ganglion (50% recurrence)
3. Surgical Excision (25% recurrence)

Question 13

List 4 specific causes of lumps in the groin

Answer 13

1. Hernia
2. Maldescended Testis
3. Varicocoele
4. Saphenovarix
5. Femoral artery aneurysm
6. Psoasabscess

Question 14

‘Undescended Testes’

Question 15

What is a Varicocoele?

Answer 15

Swelling on veins in the pampiniform plexus

Question 16

What is a Varicocoele?

Answer 16

Swelling of the veins in the pampiniform plexus

Question 17

What is a Saphenous Varix?

Answer 17

Dilation of the great saphenous vein at its junction with the femoral vein in the groin

Common surgical problem

Question 18

Presentation of a Saphenous varix

Answer 18

1. Lump in the groin
2. Bluish tinge
3. Disappears on lying
4. Venous hum may be heard on auscultation

Answer 19

Groin Lumps

Femoral artery aneurysm

• False aneurysms, also known as a pseudoaneurysm, is when there is a breach in the vessel wall which allows blood to leak through the wall but is contained by the adventitia or surrounding perivascular soft tissue.

Question 20

What is a Psoas abscess?

Answer 20

Collection of pus in iliopsoas compartment

Question 21

Most common organism in a psoas abscess

Answer 21

Staphylococcus aureus

Question 22

List 4 clinical features of a psoas abscess present?

Answer 22

1. Fever
2. Back/flank pain
3. Limp
4. Weight loss

Question 23

Examination findings of a psoas abscess

Answer 23

Pain on resisted _____ and hyperextention of the affected hip ???

Question 24

List 4 specific causes of lumps in the neck

Answer 24

1. Goitre
2. Submandibular or Parotid swelling
3. Carotid swellings
4. Branchial cyst
5. Thyroglossal cyst

Question 25

How can we differentiate between goitre vs thyroglossal cyst

Answer 25

Thyroglossal cyst will move upwards with protrusion of the tongue

Question 26

List 4 causes of thyroid swellings

Answer 26

1. Solitary nodule 2. Multinodular goitre) 3. Diffuse goitre 4. Retrosternal goitre

Question 27

List 4 causes of parotid gland swellings

Answer 27

1. Mumps 2. Stone in salivary duct. 3. Benign and malignant tumours 4. Sjögren's syndrome

Question 28

List 3 causes of Submandibular swelling

Answer 28

1. Stone in salivary duct. 2. Benign and malignant tumours. 3. Sjögren's syndrome (less common).

Question 29

What is a carotid body tumour?

Answer 29

Rare paraganglioma

Question 30

What is a branchial cyst?

Answer 30

Congenital epithelial cyst due to failure of obliteration of the second branchial cleft in embryonic development Arises on the **lateral** part of the neck Asymptomatic unless they become infected

Question 31

Where are Thyroglossal cysts located?

Answer 31

Midline of the neck between the isthmus of the thyroid and the hyoid bone

Question 32

What is a Thyroglossal cyst? What is its embryological origin

Answer 32

Remanent of the thyroglossal duct Embryologically derived from the foramen caecum