Congenital Neck Lumps – Board-Style Questions

What this deck covers

congenital neck lumps in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. One sign settles it
2. Where it began
3. Before the knife
4. The gland that stayed put
5. A hole that weeps
6. Afterwards
7. The side of the neck
8. All of it, or none of it
9. Near the ear
10. Soft and full of fluid
11. Bigger overnight
12. Planning the birth
13. What else to look for
14. Midline, but different
15. The head that will not turn
16. The shape of the head
17. What the pictures showed
18. Before you sign

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Whether it becomes painful when it is squeezed firmly, The thyroid descends from the back of the tongue, A blood count and clotting screen, A cyst filled with gland secretions, A track to the skin, following infection or surgery, No follow-up of any kind, A salivary gland lying under the jawbone, Stitching the opening closed in clinic, Injury to the nerve that moves the face, A long course of oral steroids given daily, The lesion has turned into a cancer during the night, Deliver at home, because the mass will decompress during the delivery, An underlying chromosome disorder, A cyst arising from the salivary gland under the tongue.

Clinical pearls from this deck

• A midline lump that rises with the tongue is a cyst.
• The cyst marks the path the thyroid took downwards.
• Prove there is a normal thyroid before you remove it.
• A lump at the tongue base may be the only thyroid.
• A weeping midline opening is a thyroglossal fistula.
• Check thyroid function after the cyst is taken out.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all ENT and ophthalmology case decks · pediatric reference values.