Swelling And Ulcer Case Discussion

Question 1

If there is no impulse seen in pt while coughing

It suggest

Answer 1

Cough impulse absent means Intracranial extension not there

Question 2

Transillumination in a scalp swelling will suggest

Answer 2

Cystic swelling

Meningocele

Question 3

If skin over swelling cannot be pinched it implies

Answer 3

That the swelling arises from skin

Question 4

If pt has swelling on scalp, why is it necessary to rule out swelling over rest of the body

Answer 4

Neurofibromatosis

Lipoma

Question 5

D/D of swelling on scalp can be

Answer 5

Sebaceous cyst 
Basal cell carcinoma
Meningocele 
Lipoma
Neurofibromatosis

Question 6

What is sebaceous cyst

Answer 6

It is a blocked hair follicle duct which can give rise to cyst

Question 7

How to confirm diagnosis of swelling on scalp

Answer 7

FNAC

Xray skull to rule out Intracranial extension

Question 8

Classical feature of sebaceous cyst

Answer 8

Punctum present
Fluctuation
Overlying skin cannot be pinched

Question 9

Sebaceous cyst cannot occur in

Answer 9

Palm and sole

Question 10

Dermoid cyst occurs when and usual sites?

Answer 10

Epithelial element get entrapped along lines of embryonic fusion
Site outer canthus of eye, post auricular

Question 11

Mgt of dermoid cyst

Answer 11

Excision only if no Intracranial extension

Question 12

Lymphangioma is aka

Answer 12

Cystic hygroma

Question 13

What is cystic hygroma

Answer 13

Sequestered lymphatic tissue during development

Question 14

Most common site of cystic hygroma

Answer 14

Posterior triangle of neck

Question 15

Clinical feature of cystic hygroma

Answer 15

Fluctuant
Brilliantly transilluminant
Partly compressible
Overlying skin can be pinched

Question 16

Mgt of lymphangioma

Complication of surgery

Answer 16

Aspiration and sclerotherapy (picibanil)
Definitive tt surgery
11 CN INJURY

Question 17

What is ranula

Answer 17

Mucus extravasation cyst involving sublingual gland

Question 18

Examination finding and mgt of ranula

Answer 18

Fluctuant
Brilliant transilluminant
Mgt excision of cyst and sublingual gland
Marsupialisation

Question 19

Surgical contraindication in ranula

Answer 19

Incision and drainage

Question 20

Most common nerve injured during ranula surgery

Answer 20

Lingual nerve

Question 21

Most common str injured during ranula surgery

Answer 21

Submandibular duct

Question 22

Plunging ranula is

Clinical presentation

Answer 22

Mucus retention cyst involving sublingual and submandibular gland
Swelling in neck and oral cavity

Question 23

How to differentiate between submandibular gland swelling and lymph node

Answer 23

Submandibular gland is bimanually palpable

and lymph node is not

Question 24

Hallmark feature of parotid swelling

How to know if deep lobe of parotid is involved

Answer 24

Swelling lifts ear lobule

Tonsillar fossa is pushed medially

Question 25

Thyroglossal cyst is a remnant of | Mc location of thyroglossal cyst

Answer 25

thyroglossal tract | Sub hyoid in midline

Question 26

Clinical diagnosis of thyroglossal cyst

Answer 26

It moves with deglutition and protrusion of tongue

Question 27

Sistrunk surgery is done for | Procedure?

Answer 27

Removal of cyst Tract till base of tongue and part of hyoid

Question 28

Long standing thyroglossal cyst can lead to which cancer

Answer 28

Papillary thyroid cancer

Question 29

Difference between branchial cyst and fistula

Answer 29

Branchial cyst is persistent cervical sinus | Branchial fistula occurs when there is non fusion of 2nd arch with 6th

Question 30

Location of branchial cyst and fistula

Answer 30

Cyst- ant border of sternocleiodomastoid junction of upper and middle one third Fistula ant border of scm, at junction of middle and lower 1/3

Question 31

Most common cause of cervical lymphadenopathy in India

Answer 31

Tuberculosis

Question 32

In tb cervical lymphadenopathy which lymph node is involved most common

Answer 32

Level 2 | Upper jugular LN

Question 33

To prevent formation of fistula in TB lymph node how to aspirate

Answer 33

Anti gravity aspiration from above should be done

Question 34

What is matting of lymph node

Answer 34

After caseous necrosis, inflammation of surrounding wall of lymph node i e periadenitis This leads to sticking of lymph node to each other

Question 35

What is collar stud abscess where is it seen

Answer 35

Abscess cavity below and above fistula with opening in fascia Seen in neck, it is a cold abscess