At the midline level of the hyoid bone, seems to be somehow connected to the tongue (pulling at the tongue retracts the mass)
Thyroglossal duct cyst
Occurs along the anterior edge of the sternomastoid muscle, anywhere from in front of the tragus to the base of the neck
Branchial cleft cysts
At the base of the neck as a large, mushy, ill-defined mass that occupies the entire supraclavicular area, seems to extend deeper into the chest
Cystic hygroma
Young pt multiple enlarged nodes with low-grade fever and night sweat. Dx? NSIM?
- Lymphoma
- FNA and chemotherapy
Old men who smoke and drink and have rotten teeth. Dx? NSIM?
-Squamous cell carcinoma of the mucosae
of the head and neck
- Triple endoscopy (or panendoscopy) & biopsies
Diagnostic test for Facial nerve tumors
-Gadolinium-enhanced MRI
An abscess of the floor of the mouth often the result of a bad tooth infection. Dx? NSIM?
- Ludwig angina
- I & D (might need intubation or tracheostomy)
Development of diplopia in a patient suffering from frontal or ethmoid sinusitis. Dx? NSIM?
- cavernous sinus thrombosis
- CT scans, hospitalization, IV abx, drainage
Epistaxis in a child with nose-picking. Tx?
- phenylephrine spray
- local pressure control
Epistaxis in young. Dx? NSIM?
-Cocaine abuse (posterior packing) or juvenile nasopharyngeal angiofibroma (Surgical resection)
two causes of dizziness that doesn’t involve low bp
- inner ear disease
- cerebral disease
Pt describes the room is spinning around them. Cause? NSIM?
- inner ear disease
- meclizine, Phenergan or diazepam
Pt is unsteady but the room is perceived to be stable. Cause. NSIM?
- cerebral disease
- Neurological workup needed
