A 6-year-old girl presents with a midline mass in her neck. Her parents state she has had the midline mass for some time, but they have not sought a workup because it did not bother the girl. Her parents are now seeking care because their daughter has been feeling unwell with fever and chills—as well as an increase in the size of the mass with associated redness. Examination shows a midline anterior neck mass that moves up and down on swallowing. The mass is indurated with overlying erythematous changes and no fluctuance. What is the next best step in management?

You have recently diagnosed a 60-year-old man with a neck mass consistent with metastatic p16-positive squamous cell carcinoma from an unknown primary site. You begin explaining that p16-positive tumor is one caused by the human papillomavirus (HPV), which is a known sexually transmitted virus. The man and his wife become extremely anxious on hearing this information and wonder what an HPV-associated tumor means. Which of the following can you accurately state?

A 47-year-old woman presents to your clinic with an isolated left level IV palpable lymph node. It has been present for the past 2 months and is unchanged in size. She has a history of a total thyroidectomy for papillary thyroid cancer. What is the recommended diagnostic modality?

A 51-year-old man has a total thyroidectomy and left lateral neck dissection, and 1 week later he wants to know when the surgical drain that was placed at the time of surgery will be removed. He reports that the fluid was initially clear, but it has been cloudier for the past 3 days after he ate fried chicken. He empties about 200 mL/d. How do you approach the management of this situation?

A 28-year-old man who suffered a traumatic brain injury 4 days ago currently has a Glasgow Coma Scale score of 6. A percutaneous tracheostomy is performed, and 30 minutes later the nurse reports that the patient is desaturating to 80%. What is the next best step in the management of this patient?

A 48-year-old woman is tachypneic and desaturating 6 hours after a total thyroidectomy. Her voice is hoarse when phonating. Her oxygen saturation is 84% on room air. The neck incision is intact, and there is no swelling in the area. What is the next best step in the management of this patient?

A 25-year-old healthy woman presents with a solitary, enlarged left neck mass that has been present for the past week. She reports associated cough, rhinorrhea, and fevers/chills with general malaise, which began before she noticed the neck mass. The mass is mobile and tender to palpation with some overlying skin erythema. She has pharyngeal exudates and her Strep throat swab is positive. What is the next best step in management?

A 55-year-old woman undergoes a parotidectomy for a malignant tumor of the parotid gland. Facial nerve monitoring is used. This has been associated with which of the following outcomes?

A 60-year-old man presents with a painless, enlarging, left parotid mass. Fine needle aspiration suggests the lesion is a metastatic and not a primary salivary malignancy. Which of the following is the most probable source of the metastasis?

A trauma patient presents with somnolence and no response to pain. There are facial ecchymoses, with blood in the nose and mouth. What is the next step in management of this patient?

An 80-year-old man, who sustained 50% TBSA burns, is scheduled for an elective tracheostomy for persistent respiratory failure. During the procedure, significantly calcified tracheal rings are identified, but the tracheostomy tube appears to advance without complications. While suturing the tracheal appliance phalanges into position, the anesthesiology team reports normal to low-peak airway pressures; they are progressively getting less and less tidal volume back with ventilation of the patient, and oxygen saturation is dropping. Which of the following is the best next step?

A 9-year-old girl is referred to your clinic for evaluation of a neck mass. On examination, you note a 2-cm mass in the anterior midline of her neck at the level of the thyroid cartilage. The mass moves upward with swallowing and has been stable in size for the past 6 months. This mass most likely is which of the following?

A 35-year-old man presents with a solitary left cervical lymph node that is mobile on examination. It has been present for 4 months, slowly increasing in size. What is the best initial imaging modality?

Which of the following best describe the boundaries of the submental triangle?

During a difficult neck dissection in a previously irradiated neck, the surgeon inadvertently transects what appears to be a nerve. Laryngoscopy is perfomed, which is shown in the image below. Which finding on layngoscopy is associated with the correct nerve injury in this patient?

A 62-year-old man presents for evaluation of a solitary neck mass. On examination, you note a firm, 2-cm level II lymph node. The man's history is significant for a 40 pack-year smoking history and alcohol use of four beers per day. What is the most likely cause of this neck mass?

A 21-year-old man presents with a solitary neck mass that has been present for the past 5 weeks and has been enlarging in size. He denies any recent acute illnesses and any associated symptoms, such as pain, dysphagia, or odynophagia. He was recently diagnosed with HIV. Physical examination shows a large, firm neck mass that is mobile and nontender to palpation. In addition to anti-retroviral therapy, what is the next best step in management?

Which of the following complications of tracheostomy can only occur above the tracheal stoma?

A 62-year-old postmenopausal woman with a history of hypertension and tobacco abuse presents with weight loss and an enlarged cervical lymph node. She has had a hysterectomy for uterine fibroids and a right breast partial mastectomy followed by irradiation for ductal carcinoma in situ diagnosed at age 53. Physical examination is unremarkable except for multiple enlarged lymph nodes in the left neck. Excisional biopsy of the largest lymph node demonstrates adenocarcinoma with extranodal extension. Which of the following is the most appropriate recommendation regarding management?

A 26-year-old man is involved in a motor vehicle accident leaving him with significant pulmonary contusions, traumatic brain injury, and lower extremity fractures. In discussion with his surrogate decision maker about proceeding with a tracheostomy at hospital day 3, which of the following can you assert as a benefit of early tracheostomy?

A 53-year-old man presents to your clinic with a right-sided neck mass that he noticed a few weeks ago when shaving his neck. He otherwise denies fever, difficulty breathing, voice change, dysphagia, odynophagia, or unexpected weight loss. He reports that he drinks two to three glasses of wine per week. Although he has a history of infrequent marijuana use, he otherwise denies ever smoking cigarettes or using tobacco products. After completing a thorough in-office head and neck examination, what is the next best course of action?

A 50-year-old man presents with a low-grade, malignant salivary gland tumor of the deep parotid lobe. There is no facial nerve involvement. What is the correct management?

A 72-year-old man presents with a hoarse voice, right ear pain, and pain with swallowing. He notes some difficulty breathing when laying supine but otherwise denies difficulty or noisy breathing. He has lost approximately 20 pounds of weight in the past 6 months. Of note, he has a 50-pack-year smoking history and continues to smoke 1 pack a day. As part of a thorough head and neck evaluation, a flexible fiberoptic nasopharyngolaryngoscopy is performed. During this examination, you note a right-sided hypopharyngeal tumor that appears to be centered in the pyriform sinus but clearly involves and distorts the aryepiglottic fold and at least the false vocal fold. The true vocal fold on the right is not clearly visualized, but the left appears mobile. Assuming that the man has at least a T3 or T4 squamous cell carcinoma of the larynx with no distant metastasis, you discuss the pros and cons of surgical and nonsurgical treatment options. Which of the following statements applies?