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Real Doctors (Life Makers)  |  Clinical  |  Surgery & Surgical Subspecialities.  |  Neck Swellings - MCQ « previous next »
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asabbour
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Neck Swellings - MCQ
« on: /November/ 24, 2005, 06:21:51 PM »

Neck Swellings


Dear students, these are some questions that we usually start with in clinical rounds to provoke attention. Students are usually able to answer them at the end of the cilical lesson. Try to go through them, then look for the answers and explanatory comments

1- The commonest cause of a swelling in the neck is:

1) Subcutaneous lipoma
2) Enlarged thyroid gland
3) Enlarged lymph gland
4) Enlarged submandibular gland
 


2- It is important to identify the relation of any neck swelling to the surrounding structures.
Which one of the following statements is not correct?


1)   Swellings deep to the trapezius become impalpable when the patient elevates his shoulders against resistance
2)   Swellings fixed to the trachea will move up and down with swallowing.
3)   Swellings attached to the hyoid cartilage will not move with swallowing
4)   Swellings attached to the hyoid cartilage will ascend when the tongue is protruded.



3- Recurrent bouts of tonsillitis may result in:

1)   Non specific inflammatory lymphadenopathy of the suboccipital LNs.
2)   Non specific inflammatory lymphadenopathy of the upper deep cervical LNs.
3)    Non specific inflammatory lymphadenopathy of the superficial cervical LNs.
4)   Specific inflammation of the tonsillar LNs.



4- All the following statements describe early tuberculous lymphadenopathy EXEPT:

1)   Often affects the middle and upper deep cervical LNs.
2)   The mass is neither hot nor tender and the overlying skin looks normal.
3)   The matted LNs are partially beneath and partially in front of the sternomastoid muscle.
4)   The tonsils and other tissues of the neck should be normal on clinical examination.




5- When caseation occurs and a cervical tuberculous abscess develops,

1)   The abscess is originally deep to the deep fascia partially under the sternomastoid.
2)   When a ?collar-stud? forms, the superficial part becomes less prominent when the sternomastoid contracts
3)   The skin overlying the abscess may be reddish ?purple but has normal temperature.
4)   Fluctuation may be difficult to elicit except late.



6- Metastatic malignant cervical LN enlargement is not uncommon in adults.
Which of the following statements is NOT correct?


1)   Metastatic cervical LNs are always hard and completely fixed.
2)   Metastatic LNs are not tender
3)   Thyroid carcinoma drain to the middle and lower cervical LNs
4)   Metastasis in the supraclavicular LNs commonly indicates intra-abdominal or thoracic malignancy




7- All the following carcinomas can cause secondary deposits in the upper deep cervical LNs EXCEPT:

1)   Scalp
2)   Tongue
3)   Naso-pharynx
4)   Larynx




8- The following statements are correct for primary LN neoplasms  (lymphomas) of the neck  EXCEPT:

1)   A malignant LN swelling in the posterior triangle of the neck is almost always a lymphoma
2)   With advanced LN infiltration with lymphoma, the LNs are rubbery in consistency and indistinct from each other
3)   Even with advanced infiltration, LNs with lymphomas are rarely completely fixed
4)   Lymphomas may spread to the skin causing elevated red scaly patches



9- A branchial cyst is a remnant of a branchial cleft.
Which of the following statements is NOT correct?


1)   It is present since birth but present and distend in early adult life
2)   It lies behind the anterior edge of the sternomastoid and usually bulges forwards
3)   It forms a cystic swelling which is usually tense and always give a positive trans-illumination
4)   The deep cervical LNs are classically not enlarged

Correct anwsers with explanation can be found at: http://www.medicaleducationonline.org/component/option,com_wrapper/Itemid,61/
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