THYROID CARCINOMA  -  facts to remember

• Rarest type - Anaplastic Ca
• Worst prognosis -  Anaplastic Ca
• Best prognosis - Papillary Ca
• Associated with MEN II - Medullary Ca
• Developing in thyroglossal cyst - Papillary Ca
• Least malignant -  Papillary Ca
• Developing in Hashimoto's thyroiditis - Papillary Ca
• Most common type -  Papillary Ca

ANEURYSM

Most common cause of abdominal aortic aneurysm: Atherosclerosis

Most common cause of mycotic aneurysm: Staphylococcus

BUERGER'S DISEASE - THROMBOANGITIS OBLITERANS

DEEP VENOUS THROMBOSIS -

signs & symptoms

-Unilateral leg swelling,
- Local warmth,
- Pain &  Erythema

Homan's sign (calf pain on dorsiflexion of the foot) ) is found in DVT

Doppler ultrasound (US) examination (duplex scanning) detects DVT proximal to the calf veins with >95% accuracy (disadvantage - notvery sensitive)

Ascending venography is still the reference standard. 

VARICOSE VEINS-

method of diagnosing VV: Duplex imaging

sapheno-femoral incompetence is deteccted by - Brodie-Trendelenburg test

Brodie-Trendelenburg test  - A finger is placed over the lower (distal) part of the vein being examined. The upper (proximal) part of the vein is then tapped (percussed). If the impulse is felt by the finger placed at the lower end, it indicates incompetence of valves in that vein.

ARTERIOVENOUS FISTULA/ AVF -

-Arteriovenous (AV) fistulas usually occur in the legs.

- Symptoms include red, swollen skin and purplish blood vessels and bulging veins that can be seen through the skin 

-Nicoladoni/ Branham sign ( if pressure is applied to a artery proximal to an arteriovenous fistula, swelling reduces in size, bruit and thrill will disappear, pulse rate and heart rate becomes normal )

KELOID

- It is a result of an overgrowth of granulation tissue  at the site of a healed skin injury .

 - most common site is: Sternum

BASAL CELL CARCINOMA -

BCC is a type of skin cancer. Basal cell carcinoma begins in the basal cells ( a type of cell within the skin that produces new skin cells as old ones die off).

most common type of BCC: Nodulo-ulcerative type 

Mode of spread: Direct

skin biopsy is done to diagnose BCC

MELANOMA

Melanoma occurs when the pigment-producing ( melanocytes ) cells that give colour to the skin become cancerous.

Mode of spread  -  Lymphatic channels or hematogenous
Cutaneous melanoma arises from - Epidermal melanocytes

Most malignant type  -  Noduar melanom

Biopsy and pathological examination of a skin lesion - Sometimes cancer can be detected simply by looking at your skin, but the only way to accurately diagnose melanoma is with a biopsy .

SALIVARY GLANDS -

MC benign parotid gland tumour: Pleomorphic adenoma

Muco-epidermoid Ca arises from: Mucin secreting cells & epidermal cells 

Calculi are most common in: Submandibular duct 

most common benign salivary gland tumour: Pleomorphic adenoma 

Most of the minor salivary gland tumours are: Malignant

BREAST  -

Peau D'Orange is a symptom where the skin takes on the appearance of an orange peel, .i.e. it becomes thick and pitted like an orange & this is due to Lymphatic permeation .

Risk factors for breast Ca-
- Positive family history,
- Nullipara,
- Fatty food intake,
 - Mammary dysplasia

Mondor's disease  -  Thrombophlebitis of breast .

BRANCHIAL CYST-

A branchial cyst is a cavity that is a congenital remnant from embryologic development. It is present at birth on one side of the neck and is located just in front of the large angulated muscle on either side of the neck running from just behind the ear down to the clavicle .

most common site: Upper part of neck

RANULA

A ranula is a type of mucocele found on the floor of the mouth

Retention cyst of sublingual glands.

THYROGLOSSAL CYST

-Thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during developmental stages .

-Swelling moves upwards on protrusion of the tongue as well as on swallowing (attachment with foramen caecum),

-Painless

DeQUERVAIN'S THYROIDITIS -

- also known as subacute granulomatous thyroiditis or giant cell thyroiditis', is a member of the group of thyroiditis conditions known as resolving thyroiditis.

- It is usually associated with pain and tenderness of the gland.

SOLITARY THYROID NODULE -

Most common cause of solitary thyroid nodule -  benign colloid nodules

MC in female,
Investigation of choice is: FNAC (fine needle aspiration cytology)

MEN SYNDROME ( multiple endocrine neoplasia )

-is conditions which cause overactivity and enlargement in certain endocrine glands.

MEN-I:
 - Parathyroid neoplasm, 

 - Pancreas neoplasm &
 - Pituitary (anterior) adenoma

MEN-IIA:
-  Medullary Ca (thyroid),
-  Phaeochromocytomas &
-  Parathyroid hyperplasia

OESOPHAGUS -

Most common cause of esophagitis -  Reflux esophagitis

Schatzki's ring- Schatzki–Gary ring is a narrowing of the lower esophagus that can cause difficulty swallowing (dysphagia) 

Cork screw appearance - Diffuse esophageal spasm, on barium swallow

Zenker's diverticulum - is a diverticulum of the mucosa of the esophagus, just above the cricopharyngeal muscle 

Mallory Weiss syndrome - is a condition marked by a tear in the mucous membrane, or inner lining, where the esophagus meets the stomach.

Boerhaave's syndrome -  occurs after forceful emesis 

ACHALASIA CARDIA-

BARRETTS ESOPHAGUS-