Submental lymphadenopathy

​
How can the chest x-ray be negative?

My health anxiety is skyrocketing right now. I just got my neck US result and the result doesnt seem good. I’m freaking out because of the nodule seen in my thyroid left lobe. I also have swollen lymph node above my right collarbone for more than 2 weeks now. I’ve been taking co-amoxiclav as prescribed by my ENT. im on my 5th day and it hasn’t cleared up. Can someone help me ease my mind pls?
this is my neck and thyroid ultrasound result.
Thyroid: Normal ni size with homogeneous parenchyma and normal vascularity on color Doppler interrogation. Isthmus is not thickened (0.14 cm). Right thyroid lobe - 4.4 x 1.27 x 1.11 cm; Left thyroid lobe - 4.36 x 1.57 x 1.33 cm
A nodule is seen in the left lobe described below: .1 Lower: Solid, Isoechoic, wider than tall with smooth borders and internal calcifications measuring 2.17 x 1.28 x 1.09 cm - TIRADS 4, Tissue correlation (FNAB) is suggested.
No lesions are seen in the right thyroid lobe and isthmus. Parotid and submandibular glands: Unremarkable
Lymph nodes: Prominent sized to enlarged lymph nodes with absent fatty hila are seen in the right supraclavicular region with the largest having a short axis diameter of 1.03 cm. Unenlarged lymph nodes with intact fatty hila are seen in the submental, bilateral submandibular, jugulocarotid, posterior cervical and left supraclavicular regions.
IMPRESSION: Normal sized thyroid gland with left nodule as described above. Cervical lymphadenopathy, right supraclavicular region.

NBME CBSE ACTUAL TEST QUESTIONS AND
ANSWERS (Quiz bank with all the correct answers)
(usmle step 1) Medical examination
62 year old woman - osteoporosis - a bisphosphonate is prescribed. The expected
beneficial effect of the drug is due to which of the following? -Answer- Decreased
Osteoclast Activity
Cohot Study of elderly women - relative risk ratio for hip fractures among those who
exercise regularly is 1.2 (95% confidence interval of 1.1 to 1.8). Which of the following is
the conclusion about the effect of exercise on the risk of hip fracture? -AnswerStatistically Significant Overall Increase Risk
52 year old man goes to ER with chest pain radiating to his jaw while shoveling snow.
Pulse is 80/min and blood pressure is 130/70. The most immediate treatment
mechanism of action? -Answer- Increased nitric oxide concentration
24 year old woman - spilled hot grease on her left leg while working at a fast-food
restaurant. Exam of leg shows 7cm pink, soft, granular, edematous wound. The
formation of this tissue was most likely caused by increased activity of which? -Answera. Vascular Endothelial Growth Factor
VEGF - stimulates angiogenesiss.
TYPE III Collagen = Blood Vessels - early wound repair
27 year old man- MVC - skull x-ray shows a linear, nondepressed basal skull fracture -
increased serum osm and decreased urin osm. Following desmopressin urine osm
increases. Desmopressin's effect is due to the activation of which of the following? -
Answer- a. Adenylyl Cyclase
Adenylate Cyclase - ATP - CAMP -- PROTEKINASE A -- Ca
v2
A 10 month old boy - 4 day history of fever and cough. He attends day care center.
Chest exam shows intercostal retractions along with bilateral, diffuse wheezes and
expiratory rhonchi. The infectious agent most likely has which of the following
properties? -Answer- Mediation of Cell Entry via a fusion protein
A 17 year old girl in ED - 15 minutes after being stung by a bee. Mild light headedness
but no difficulty swallowing- Bilateral wheezing - Which is most appropriate
pharmacotherapy for this patient? -Answer- B2- Agonist
14 year old boy - 2 day history of sore throat and fever that peaks in late afternoon. 1
week of fatigue. He recentaly had sex with one partner. Physical exam show cervical
lymphadenopathy and pharyngeal erythema with a creamy exudate. DX? -AnswerInfectious Mononucleosis
​
57 year old man - radiation therapy for squamous cell carcinoma of the lung. Despite
therapy, tumor increases in size and he dies 6 months later. The progressive tumor
growth is due to a defect in cell cycle arrest in which of the following phases of cell
cycle? -Answer- G1
28 year old - lived in sub-Saharan Africa - until he came to the US. Temp of 100.4 -
imaging shows bilateral hydroureter and hydronephrosis. Biopsy shows marked fibrosis
and scattered granulomas. DX? -Answer- Schistosomiasis
A couple with a family history of a-thalassemia. Woman has one gene deletion and man
has two gene deletion. If the two gene is trans - what percentage of offspring will have a
two gene deletion? -Answer- 50%
previously healthy 40 year brought to emergency department by her husband - 2 day
history of fever, lethargy, confusion. PE shows scattered petechiae and ecchymoses
over the lower extremities - 3+ polychromasia and 3+ schistocytes and Low platelets
Dx? -Answer- Thrombotic Thrombocytopenia Purpura
16 year old boy - is admitted to the ER because of a knife wound to the left side of his
chest. An X-ray of the chest shows an air-fluid level in the left side of the chest, partial
collapse of the left lung, and the elevation of the stomach bubble. The mediastinum is
midline. DX? -Answer- Hemopneumpothorax under tension
49 year old woman - coronary artery disease - BP 140/90 - High Cholesterol, High LDL
(190), High triglycerides (350) - TX with atorvastatin and losartan. What are the effects
on HDL and Triglycerides? -Answer- HDL increased
Triglycerides Decreased
73 yeare old - diffuse weakness and tingling of her arms and legs. Sensation and
vibration and position is decreased in all extremities. What vitamin deficiency? -AnswerVitamin B12 - (cyanocobalamin)
Tea and Toast - low B12 in diet
15 year old girl - 3 month history of acne - which is the underlying cause of the patients
acne? -Answer- Stimulation of Sebaceous Glands by androgens
b. ACNE = Propionibacterium ACNE
4 year old from Brazil - PE shows single 12x10cm lesion in the right side of jaw with
diffuse regular edges. Photomicrographs of an incisional biopsy (looks like Burkitts
Lymphoma/ Starry night) - which of the processes most likely to occur in the region
indicated by the arrow? -Answer- Apoptosis
b. Endemic Burkitt lymphoma can happen in Brazil as well as Africa (jaw lesion, puffy
face).
​
51 year old - lump on tongue - 1 pack smoking history for 30 years. 1.5 cm mass on
apex of tongue. It is most appropriate to evaluate which lymph nodes first for evidence
of metastasis? -Answer- Submental
15 year old boy - ER - 2 hour history of confusion and agitation - fever, headache, stiff
neck, and vomiting - since returned from summer camp - patient is hallucinating -
lumbar puncture - shows cysts and trophozoites- most likely pathogen? -Answer- a.
Olfactory Nerve
Naegleria fowleri
17 year old - ED - 30 minutes after being found with a blank stare. Physical exam shows
rigidity. During exam he becomes hostile and assaults physician - Pt ingested which
drug? -Answer- PCP
Placebo controlled clinical trial - 5000 pts with essential hypertension. 2500 patients
receive new drug and 2500 patients receive placebo. If alpha is set at 0.01 instead of
0.05, which of the following is most likely result? -Answer- Significant findings can be
reported with greater confidence
17 year old - gymnast - comes to hospital because of lack of menstrual period for 6
months. BMI 15 Which is the cause of the amenorrhea? -Answer- Hypogonadotropic
Hypogonadism
A male stillborn is delivered at 32 weeks - Oligohydramnios - absence of a urethral
opening. Which is most likely finding? -Answer- Pulmonary Hypoplasia
A 6 day old - breast fed boy in ED - poor weight gain and irritability since delivery -
Physical exam shows jaundice and hepatomegaly. The concentration of which of the
following metabolites is most likely increased? -Answer- a. Galactose - 1 - phosphate
b. Congenital intolerance to breast milk
A 25-year-old man - comes to ED - severe muscle pain, diffuse, painful swelling of his
neck, underarms, and groin after camping in New Mexico Generalized scattered black
maculae. Examination of the right upper extremity shows erythematous, solid, tender
mass. Mass is draining blood and necrotic material. The most effective antibiotic for
patient disorder will interfere with which of the following processes? -Answer- a.
Ribosomal Assembly
b. Yersenia Pestis
45 year old - progressive weakness - muscle fasciculations of the upper extremities and
weakness of the lower extremity - What additional findings? -Answer- Atrophy
b. ALS = Lou Gherig
A new severe respiratory illness - Why use a killed vaccine vs a live vaccine? -AnswerAvoids Concerns of reversion to virulence
b. Killed vaccines - avoids reversion to virulence
​
c. live vaccines - can (but rarely do) cause the disease they're designed to prevent
A 33 year old - keratinizing squamous cell carcinoma of cervix. Which of the following
describes pathogenesis of this patient's disease? -Answer- Inactivation of Cellular P53
b. p53 protein = tumor suppressor (it activates apoptosis) - most human cancer
A 54 year old - 40 year history of T1DM - receiving hemodialysis for end stage renal
disease while awaiting a kidney transplant. Receives a drug that induces reticulocyte
release from bone marrow and stimulates a cytokine receptor that signals Jak/Stat
pathway? -Answer- Erythropoietin
Jak Stat - erythropoietin
During a clinical study examining the effects of exercise. The average pulse is 175/min.
Compared with measurement before the session, which is most likely decreased? -
Answer- Total Peripheral Resistance
An 8-year-old boy - 3-day history of fever, sore throat, and itchy eyes. Returned from
week long summer camp that includes hiking trips and swimming - PE shows
conjunctival injection and oropharyngeal edema - Outbreak among other campers.
Which is most likely cause of this patient's symptoms? -Answer- Adenovirus
Fever+ Sore Throat + Itchy Eyes
transmitted via swimming pools
Conjunctivitis Viral = adenovirus
44-year-old woman - 10 month history of wide red streaks over her lower trunk (striae)
and weight gain in face (moonface). Which additional findings? -Answer- Hypertension
and muscle weakness
b. Cushing - hypertension and muscle weakness
12 year old boy - pain below left knee -unable to play soccer - An x-ray shown - Which
structures attached to the abnormal anterior tibial area? -Answer- patellar ligament
b. Osgood-Schlatter
A 65-year-old health maintenance exams - He lives is a single-family home with his cat
and dog. He spend much of his time in his basement woodworking shop. This patient is
increased risk for lung cancer due to which of the following environmental exposures? -
Answer- Radon
54-year-old man - intense overwhelming fear. Which portion of brain stimulated? -
Answer- Amygdala
b. Fear = amygdala
30 year old woman - recurrent URI - Sweat is Salty- Genetic testing for 36 most
common mutations shows detectable G551D in one allele of CFTR - What is patients
clinical phenotype? -Answer- The Second CFTR Gene was not detected by the testing
obtained
​

NBME CBSE ACTUAL TEST QUESTIONS
AND ANSWERS
62 year old woman - osteoporosis - a bisphosphonate is prescribed. The expected
beneficial effect of the drug is due to which of the following? Correct answer- Decreased
Osteoclast Activity
Cohot Study of elderly women - relative risk ratio for hip fractures among those who
exercise regularly is 1.2 (95% confidence interval of 1.1 to 1.8). Which of the following is
the conclusion about the effect of exercise on the risk of hip fracture? Correct answerStatistically Significant Overall Increase Risk
52 year old man goes to ER with chest pain radiating to his jaw while shoveling snow.
Pulse is 80/min and blood pressure is 130/70. The most immediate treatment
mechanism of action? Correct answer- Increased nitric oxide concentration
24 year old woman - spilled hot grease on her left leg while working at a fast-food
restaurant. Exam of leg shows 7cm pink, soft, granular, edematous wound. The
formation of this tissue was most likely caused by increased activity of which? Correct
answer- a. Vascular Endothelial Growth Factor
VEGF - stimulates angiogenesiss.
TYPE III Collagen = Blood Vessels - early wound repair
27 year old man- MVC - skull x-ray shows a linear, nondepressed basal skull fracture -
increased serum osm and decreased urin osm. Following desmopressin urine osm
increases. Desmopressin's effect is due to the activation of which of the following?
Correct answer- a. Adenylyl Cyclase
Adenylate Cyclase - ATP - CAMP -- PROTEKINASE A -- Ca
v2
A 10 month old boy - 4 day history of fever and cough. He attends day care center.
Chest exam shows intercostal retractions along with bilateral, diffuse wheezes and
expiratory rhonchi. The infectious agent most likely has which of the following
properties? Correct answer- Mediation of Cell Entry via a fusion protein
A 17 year old girl in ED - 15 minutes after being stung by a bee. Mild light headedness
but no difficulty swallowing- Bilateral wheezing - Which is most appropriate
pharmacotherapy for this patient? Correct answer- B2- Agonist
14 year old boy - 2 day history of sore throat and fever that peaks in late afternoon. 1
week of fatigue. He recentaly had sex with one partner. Physical exam show cervical
lymphadenopathy and pharyngeal erythema with a creamy exudate. DX? Correct
answer- Infectious Mononucleosis
​
57 year old man - radiation therapy for squamous cell carcinoma of the lung. Despite
therapy, tumor increases in size and he dies 6 months later. The progressive tumor
growth is due to a defect in cell cycle arrest in which of the following phases of cell
cycle? Correct answer- G1
28 year old - lived in sub-Saharan Africa - until he came to the US. Temp of 100.4 -
imaging shows bilateral hydroureter and hydronephrosis. Biopsy shows marked fibrosis
and scattered granulomas. DX? Correct answer- Schistosomiasis
A couple with a family history of a-thalassemia. Woman has one gene deletion and man
has two gene deletion. If the two gene is trans - what percentage of offspring will have a
two gene deletion? Correct answer- 50%
previously healthy 40 year brought to emergency department by her husband - 2 day
history of fever, lethargy, confusion. PE shows scattered petechiae and ecchymoses
over the lower extremities - 3+ polychromasia and 3+ schistocytes and Low platelets
Dx? Correct answer- Thrombotic Thrombocytopenia Purpura
16 year old boy - is admitted to the ER because of a knife wound to the left side of his
chest. An X-ray of the chest shows an air-fluid level in the left side of the chest, partial
collapse of the left lung, and the elevation of the stomach bubble. The mediastinum is
midline. DX? Correct answer- Hemopneumpothorax under tension
49 year old woman - coronary artery disease - BP 140/90 - High Cholesterol, High LDL
(190), High triglycerides (350) - TX with atorvastatin and losartan. What are the effects
on HDL and Triglycerides? Correct answer- HDL increased
Triglycerides Decreased
73 yeare old - diffuse weakness and tingling of her arms and legs. Sensation and
vibration and position is decreased in all extremities. What vitamin deficiency? Correct
answer- Vitamin B12 - (cyanocobalamin)
Tea and Toast - low B12 in diet
15 year old girl - 3 month history of acne - which is the underlying cause of the patients
acne? Correct answer- Stimulation of Sebaceous Glands by androgens
b. ACNE = Propionibacterium ACNE
4 year old from Brazil - PE shows single 12x10cm lesion in the right side of jaw with
diffuse regular edges. Photomicrographs of an incisional biopsy (looks like Burkitts
Lymphoma/ Starry night) - which of the processes most likely to occur in the region
indicated by the arrow? Correct answer- Apoptosis
b. Endemic Burkitt lymphoma can happen in Brazil as well as Africa (jaw lesion, puffy
face).
​
51 year old - lump on tongue - 1 pack smoking history for 30 years. 1.5 cm mass on
apex of tongue. It is most appropriate to evaluate which lymph nodes first for evidence
of metastasis? Correct answer- Submental
15 year old boy - ER - 2 hour history of confusion and agitation - fever, headache, stiff
neck, and vomiting - since returned from summer camp - patient is hallucinating -
lumbar puncture - shows cysts and trophozoites- most likely pathogen? Correct answera. Olfactory Nerve
Naegleria fowleri
17 year old - ED - 30 minutes after being found with a blank stare. Physical exam shows
rigidity. During exam he becomes hostile and assaults physician - Pt ingested which
drug? Correct answer- PCP
Placebo controlled clinical trial - 5000 pts with essential hypertension. 2500 patients
receive new drug and 2500 patients receive placebo. If alpha is set at 0.01 instead of
0.05, which of the following is most likely result? Correct answer- Significant findings
can be reported with greater confidence
17 year old - gymnast - comes to hospital because of lack of menstrual period for 6
months. BMI 15 Which is the cause of the amenorrhea? Correct answerHypogonadotropic Hypogonadism
A male stillborn is delivered at 32 weeks - Oligohydramnios - absence of a urethral
opening. Which is most likely finding? Correct answer- Pulmonary Hypoplasia
A 6 day old - breast fed boy in ED - poor weight gain and irritability since delivery -
Physical exam shows jaundice and hepatomegaly. The concentration of which of the
following metabolites is most likely increased? Correct answer- a. Galactose - 1 -
phosphate
b. Congenital intolerance to breast milk
A 25-year-old man - comes to ED - severe muscle pain, diffuse, painful swelling of his
neck, underarms, and groin after camping in New Mexico Generalized scattered black
maculae. Examination of the right upper extremity shows erythematous, solid, tender
mass. Mass is draining blood and necrotic material. The most effective antibiotic for
patient disorder will interfere with which of the following processes? Correct answer- a.
Ribosomal Assembly
b. Yersenia Pestis
45 year old - progressive weakness - muscle fasciculations of the upper extremities and
weakness of the lower extremity - What additional findings? Correct answer- Atrophy
b. ALS = Lou Gherig
A new severe respiratory illness - Why use a killed vaccine vs a live vaccine? Correct
answer- Avoids Concerns of reversion to virulence
​
b. Killed vaccines - avoids reversion to virulence
c. live vaccines - can (but rarely do) cause the disease they're designed to prevent
A 33 year old - keratinizing squamous cell carcinoma of cervix. Which of the following
describes pathogenesis of this patient's disease? Correct answer- Inactivation of
Cellular P53
b. p53 protein = tumor suppressor (it activates apoptosis) - most human cancer
A 54 year old - 40 year history of T1DM - receiving hemodialysis for end stage renal
disease while awaiting a kidney transplant. Receives a drug that induces reticulocyte
release from bone marrow and stimulates a cytokine receptor that signals Jak/Stat
pathway? Correct answer- Erythropoietin
Jak Stat - erythropoietin
During a clinical study examining the effects of exercise. The average pulse is 175/min.
Compared with measurement before the session, which is most likely decreased?
Correct answer- Total Peripheral Resistance
An 8-year-old boy - 3-day history of fever, sore throat, and itchy eyes. Returned from
week long summer camp that includes hiking trips and swimming - PE shows
conjunctival injection and oropharyngeal edema - Outbreak among other campers.
Which is most likely cause of this patient's symptoms? Correct answer- Adenovirus
Fever+ Sore Throat + Itchy Eyes
transmitted via swimming pools
Conjunctivitis Viral = adenovirus
44-year-old woman - 10 month history of wide red streaks over her lower trunk (striae)
and weight gain in face (moonface). Which additional findings? Correct answerHypertension and muscle weakness
b. Cushing - hypertension and muscle weakness
12 year old boy - pain below left knee -unable to play soccer - An x-ray shown - Which
structures attached to the abnormal anterior tibial area? Correct answer- patellar
ligament
b. Osgood-Schlatter
A 65-year-old health maintenance exams - He lives is a single-family home with his cat
and dog. He spend much of his time in his basement woodworking shop. This patient is
increased risk for lung cancer due to which of the following environmental exposures?
Correct answer- Radon
54-year-old man - intense overwhelming fear. Which portion of brain stimulated?
Correct answer- Amygdala
b. Fear = amygdala

25 year old Female My left submandibular lymph node has been swollen since 9/22 since then, my doctor has noted cervical lymphadenopathy as you can feel quite a few lymph nodes in my neck. My doctor has tested me for EBV which came back that I have had it in the past. Vca (IgM) - <36 U/mL Vca (IgG) - 96 U/mL Ebna (IgG) - 61.7 U/mL My doctor let me know that EBV can cause lymphoma and that all of his patients with lymphoma have EBV. Had an ultrasound guided fine needle aspiration on 3/18/23 (two weeks ago) and still haven't gotten the results back yet. The radiologist noted "The target lymph node was found by palpation and correlating to small 11 x 5 mm lymph node with prominent cortex in the submental region towards the angle of the mandible." The radiologist also said "yeah, I don't like that" while she was looking at the ultrasound before the biopsy. Can anyone tell me if prominent and thickened cortex mean the same thing as well as what I could be possibly expecting? Thank you,

Anyone have anything similar? Wondering what I should do next. This is after a neck US with large lymph nodes in December.
PROCEDURE: CT SOFT TISSUE NECK W/
INDICATION: Generalized enlarged lymph nodes R591. .
Bilateral jugulodigastric nodes measuring up to 20 mm level 3. Small nonspecific bilateral cervical lymph nodes not grossly enlarged. Bilateral submandibular mild lymphadenopathy and submental adenopathy is present. Right submandibular lymph node largest up to 10 mm. Several small submental lymph nodes are identified.
Thyroid glands unremarkable.
Small supraclavicular and axillary lymph nodes are noted there are not grossly enlarged. No significant superior mediastinal adenopathy identified.
Lung apices are clear.
Bony structures are intact.
IMPRESSION: Nonspecific cervical adenopathy noted. Likely reactive adenopathy. Most prominent noted in the jugulodigastric chain bilaterally level 3
Small bilateral submandibular and submental lymph nodes and posterior cervical lymph nodes are seen. Clinical correlation advised. Follow-up recommended as necessary.

Age 48
Sex m
Height 6
Weight 150
Race white
Duration of complaint since 2016 worse present progressive.
Location Ontario
Any existing relevant medical issues lots
Current medications Diclofenac melatonin
Include a photo if relevant
There alot history so please don't bash me. History of Lyme bartonellosis hemoragging neck mass. Phyrygeal dysphagia w aspiration Barrett's esophagus, got worse by covid sars in April. Brought back old symptoms of Lyme bartonellosis. Lose of collagen burning sticky waxy skin with subcutaneous fluid filled tissues bones spinal cord compression stiffness cracked ng brittle bones. Can't speak chew swallow cough clear breathe. Drooling choking regurgitation best nging up acid saliva thick no mucus production. Cauliflower or cellulitis ear swollen red turned hard with tonsil abcess submandibular abcess loss breathing muscles cramping shrinking neck trunk obliques diaphragm Heavy limp belly with lumps everywhere chemical burns across lower ribs sternum down center of abdomen along esophagus stomach bladder radiates into bladder growing hips knees feet numbness burning pressure and pain balls of feet vascular pain chills sweating. Liver lesion thyroid neoplasm follicular. Facial cavity is atrophied with lumps unders cheeks now. Can't stand straight. Abcess ruptured on right forearm. Cramping shrinking tendons ligaments in limbs .swollen burning fishing lips crusting nose skin face thinning and red ear eyes with bacterial sores smoking making everything break down. Never like this before. There's alot more I'm basically walking vegtable jumping around rattle from throat body try to cough and clear breath at same time from shrinking and breaking down of tissues bones and nerves. Belly pulls down on everything.smoking seems to be coming out of skin and causing apoptosis to my internals all connective tissues. Can't touch my tongue tonsils gums and upper neck abcess with my swelling squeeze locking up my back day. Will Post later. Angry at doctors haven't been any where in a year.
Past Diagnosis: not all info here Other imaging at Chatham hospital and clear water imaging
All this since my infections of Bartonella Lyme and coinfections. I believe my first antibiotic for my gum infections 2016 ,brought out infections already in me terrible side effects as discussed with dr Mallette a while back it's a strong theory. All these finding within we short Time. Do math. Never been to drs my whole life pretty much.
Tons of scans injections gadolinium and contrast. Meds. Part of problem as well
Suspected Tia 2012
Hpncc mutation gene stomach colon Lynch syndrome all males on fathers side.
Enhance flair level of the pons T2 MRI 2013
Chronic Anemia bruising balding bleeding into skin difficulty breathing not anxiety tissues muscles circulation spine etc no further investigations infections, Cancers highly suspected based on incomplete biopsy read what happened? Most probably. Never had until Bartonella. RBC hematocrit hemoglobin at times... Was very low in hospital a while back concerning low no investigations into why. That's y I said my chronic infections bacterial fungal or hidden or denied between thyroid liver neck and Throat something s there. Multi systemic conditions happening at same time same background same triggers.
Lymphadenopathy neck and submandibular armpit and groin. Bartonella infection and mixed zoonotic infections reactive with sars covid and new symptoms from covid debilitating. I'm a long hauler now.
Updated I believe I have a strong case of cellulitis systemically you really see it in my right ear affecting all my skin mucosal membranes muscles bones Spine skull blood vessels lymphnodes lymphatic system for sure. Meds and cigs have been complicating more severely after sars covid, especially with broken throat and zoonotic infection past and present every inch of my body. Speaking chewing swallowing breathing choking regurgitation bringing up acid saliva thick mucus. Read symptoms I'm doing well the rattle in throat submandibular is for sure abcess and possibly cellulitis with all other stuff. Eating and deterioration scarring if my innereds mucus membranes skin facial cavity bone marrow all that's stuff connective tissues spine summary.
Bartonella Lyme considered autoimmune infections due to the immunomodulatory effects. They also infiltrate the epithelial cells blood vessels lymphnode proliferation of erythrocytes, live in non accessible compartments outside the immune system, they attack intracellular compromising immune. Also shape shift to anything to avoid immune. The term stealth vectors, is used for this infections. Hard to detect later through blood work especially if immune is low. Laryngeal epithelial proliferation, human umbilical vein, bacillary angiomatosis. Liver pretty much everywhere. Lyme Borrelia OSP C binds to complement C4b lives in the mid gut and everywhere. My labs showed osp c 23 41and 39 I believe.
Scope of stomach original 2017 found rare pylori like organisms. Rare turned out to haemophimus bartonellosis. No proper antibiotics given no investigations of rare pylori like organisms done except by me and dr Quan was advised and agreed. Whole situation could of been totally avoided from start. Condition has turned Chronic with the other co infections to present date on top of everything else going on now.
Phyrngeal dysphagia w aspiration as per hilal. Came with Bartonella Lyme and confections. True neuromuscular disease as he told me. Undiagnosed. Just like connective tissue degenerative changes.
Orthostatic: hypotension, Bartonella Lyme coinfections
Evolving abcess left neck nothing done/again most probable bacterial infection like everything else. 2020 19? Or cancer
Left neck mass and submental masses submandibular, ultra sound 2020 routine thyroid scan of thyroid follicular neoplasm tirade 4 catagory
Left right inguinal hernias indirect and direct getting worse from spine compression. Lumbar facet joint injections L5s1 was wrong type of injection
Tonsilar inflammatory/infectious from CT scan from dr long 2019 no treatments Salivary gland masses and infections 2019 no treatments Abdullah.
Significant ostiomeadal narrowing no info, promenace of the Palestine tonsils infectious inflammatory. No follow up or treatment. July 2019
Gallbladder polys
Hemmoriging neck mass large us shows infection most probable and growing fast 5 x6x8cmv or SCCarcinoma. Biopsy incomplete ruled as inflammatory cause core sample couldn't be taken as contents were drain 2 weeks prior. Poor diagnosis totally wrong. Still stands in my book infections vs SCC as per MRI and ultrasound and high NC ratios and other terms mentioned through biopsies. Core biopsy should have been first not last. Infections cancer are inflammatory. Based on all my symptoms somethings wrong here. Mass was there long before I started moving thyroid cartilage aside slight to swallow now it apparent it completely scarring and narrowed and deteriorated collapsing with esophagus Spine with the shortening of my respiratory muscles and back. Ties into ear eustachian tubes nasal oral throat salivary glands throat esophagus fried dried burning etc. Stomach pain vomitting nausea swelling pain n above naval into upper esophagus. See regurgitation choking swallowing.
Candida like symptoms more dibilatating
connective tissue degenerative wasting secondary causes by chronic bacterial fungal covid infection meds smoking exacerbating causing deteriorating and severe loss of collagen with pigmentation changes brownish painful with subcutaneous lumps. Meds depleting moisture and necessary fluids from glands mucus saliva thick or none and bones.
Chronic ear infections eye infections skin infections sinus tonsils salivary glands throat and now esophagus stomach no treatment and I'm sure my bones joints and spine possibly brain based on symptoms, with Severe inflammation.
Nasal hands telangiectasia, erythromomelanosis coli face and neck, and pressure uticaria vs uticaria vasculitis hands. 2018 Dr Tan, most probable Lyme bartonellosis
Tons CT csans radiation, great for my immune and tissues bones nerve function. Low IgG subclass1 mildly always Low cd 8+ t cells flow cytometry 2019 no follow up, dr zanganah. Another clue hint immune infections meds have copies of everything almost. Severe tonsilar vocal cord asymmetry from either infection or cancer no follow up just like all other infections lymphnodes or possible Cancer. Scanned CT confirmation 2019 inflammatory infectious. Just like everything thing else.
Costochondritis 2019 most probable Lyme bartonellosis. Common findings " mean Lyme my st probable Bartonella Pleural effusion 2016, 17 and now " Chronic knees effusions 2018 2022 " Otitis media 2019 with effusion 2022 " Palmer erythema 2016 2022 worsening " Pericardial effusion 2016 ,17 Bartonella. " infection most probable. No follow up no treatments. No other reasons but infection. Tricuspid regurgitation, enlarged left sided heart valve
Low manganese through 24hr urine blood Zinc Vit d
Diptheria shot one year after deep cut for finger had surgery with no vaccine at time. Things got worse after shot dr zanganah. Eustachian tube disfunction burning inflammation before. Worse now will mucosal membranes affecting ear lobes stiff and bear with sores. He felt something going on with CNS and immune connective. Eustachian tube disfunction was starting up. This after my zoonotic infections a year after or so with my jaw joint ating up with spine and other stuff with gastric and throat and muscles of breathing.
Severe chronic sinus infections strong burn ing odor green to white to clear yet tissues are dried out burning into eyes ears mouth throat salivary glands lymphatic and esophagus massive hernias lumps severe reflux and swelling like achalasia like symptoms regurgitation choking vommit acide cough blood nasal discharge burning drooling uncontrollable.
Polyneuropathy Dr Charron 2018?
Tandem gait ataxia 2018 Dr mustafa
Barretts esophagus stomach polyps Dr Tarabain dialtion months ago made worse esophageal strictures worsening 2022 now Thyroid follicular neoplasm class 4 2016 Tons of liver lesions, suspected hemangiomas or carcinoid metastatic or other unusual pathologies as per Dr Ala not 100 percent accurate. None prior month on MRI w/contrast. Bartonellosis Lyme Most probable, cancer? Perhaps
Pancreatic cysts head and tail no follow up Kidneys cysts, colloid, bosniak level 3 and masses no follow up Possible scarring damage diaphram abdomen wall. Ultra sound tech asked if I had past surgery in that area while scanning 2 years back clear imaging. No notes made
Neuro muscular motor neuron disease Dr Tawil Chatham swallowing issues from scope before hilals official diagnosis Neuro muscular condition Dr hilal from phyryngeal dysphagia. Bartonellosis Lyme coinfections.
Phyrngeal dysphagia with aspiration Hemmoriging neck mass large us shows infection most probable and growing fast 5 x6x8cmv or SCC Neuro muscular condition pharyngeal muscles and other muscles seen Dr Hilal True neuro in origin as per his quoted words when I asked him. immuno neuro inflammatory response mediated , affecting all connective tissues bones joint spine and nerves, infections bacterial fungal viruses then covid sars made everything go to hell. Meds toxins cigs secondarily worsening condition. Dr Mallette no sure acknowledged symptoms. Not the latest updates. She agrees there is definitely something going on.
Follicular neoplasm thyroid 2016 Moderate xerostomia dr staple ford 2018 possible lichen planus dr staple ford. Salivary glands infections and masses no treatment 2018 with complex masses in submandibular region. No treatments or not investigations
Very High cadmium levels urine 2019? Very High antimony metals urine blood 2019?
2012 Vasomotor rhinitis non allergic rhinitis. Severe allergy like symptoms: meds smoking infections for sure. Chronic sinus air way inflammation infections.
Pneumoniae once In awhile Gynecomastia 2014 1x1x1cm Low testosterone blood Dr Banner 2019
Chronic reactive lymphnodes large everywhere. Bartonellosis Lyme cancer?
Bone tumors swelling ribs clavicle left rib near thymus swollen lymphnodes neck above clavicle upper chest Wall near throat. Hips pelvic femur shoulders very painful. All bones joints spine numbness tingling loss sensation ice picks pulsating.
Dermatographism as per dr Aktas started with Bartonella infection/Lyme hga. Came back after covid struck as well other infections bacteria fungi inside outside body with facial droop right sided mouth.
High cd4cd8 ratio most probable infections or cancer based of on biopsy undetermined atypical neck mass or my thyroid neoplasm liver lesions tons of them. Low IgG subclass1 mildly always Low cd 8+ t cells flow cytometry auto immune immune based obviously. Manganese deficiency low via urine blood
Thyroid always on low end .30 avg all most subclinical hyperthyroidism at times Thyroglobulin very high 89 avg Thyroid neoplasm follicular 2016
Always low Vitamin D all year around avg 20 Low IGM Low Cd57 NK cells
Myopathy biopsy 2018 as according to notes on addem from quad biopsy shamisa as the most probable based on addendum not original. It originally said myelopathy which I have with all the stenosis no follow up with the stress fractures, as well confirmed his colleague. Said there's no such thing from biospy it should read myopathy end his quote. could this be an infectious myopathy. Which one is it. No follow up with Dr Mustafa. Lyme bartonellosis? Was told had myelopathy in the past
Chronic skin bacterial fungal infections Tetanus like symptoms and connective tissue type symptoms secondary 95percent if I can't speak well and breath swallow and move funny rattle from hyoid Bone. See other notes. Pinna perichondritis or cellulitis at this point came with Bartonella, covid made worse getting worse systemically.
Cervical and Thoracic lumbar changes subluxation hypertrophy Multi level central stenosis c3c4 c567 c3,4 being worst etc worsening now c1 and2 subluxation guaranteed Grade 3 or worse old report. Spondylolisthesis Causing diaphragm and accessory muscles paralysis from neck down. With a collapsed atrophied infected throat and esophagus. No follow up. Now completely paralysing me. Severe weak cough due to breathing muscles paralyzing neck downward and trachea is cracked and broken at esophagus collapsed major esophageal strictures or cancer infection hernia into belly into bladder groin. Collagen loss not helping Radiculopathy history cervical spine from fall. Bending spine thoracic most visible. Lumbar severe dissection hyperlordosis multilevel stenosis severe bulging and other stuff. old data. Spine is now stiff cracking drying out burning cracking compression causing Major issues in body. Severe bend out ward in spine as a whole. Skull base to tailbone. vertebrates all cracking and crunching with sharp shooting burning pains all the way down from skull base cervical thoracic felt in throat jaws esophagus into lumbar from other muscles, tissues collagen, mucosal membranes breaking down. Chronic gastritis drooling choking regurgitation vomitting acid saliva weak unproductive cough from muscle and Throat. Loss of bladder control numbness tingling and loss sensation of small toes neck limbs vascular pain inflammation phlebitis starting in hand etc. Lumb weakness cramping of legs tendon ligaments muscles with left arm and neck scm muscle bulging back muscles with back neck.
White matter changes brain Chatham hospital. Nothing 1 year prior. Happened after Bartonella 2016/ Lyme anaplasmosis infection 2018 which was all reactive 2years later and again after covid April 2022 Agiogram brain narrowed mca M2 segment left side from either trauma or other forms of vasculopathy infection.
Tarlov spinal cysts
Bleeding pus filled leaking from older neck biopsy from dr Gill under chin. Happened 6 months back from July 2018 no treatment for bacterial infection no treatments IgG subclass deficiency 1&2
Tons of liver suspected hemangiomas 2018 no biopsy. Liver pain present day Infectious inflammatory dystrophic calcification palatine tonsils CT scan 2019 dr ling no treatment. Still active Salivary glands infection no treatments 2019 still active
Tons of CT scans antibiotics for bacterial and Fungal infections 6 in 1 year. Nystatin make my body go wild. Last antibiotic cefuroxime made things worse for suspected nasal infection. Viral? Chronic since med use.
Past Barrett's esophagus. Recent Dilation from scope after made things worse. 3 weeks of stomatitis severe. Current severe gastritis coughing up blood thick chunky with esophagus or trachea from old break and scarring eroding narrowed stricture?. From meds infection cigs. No follow up on Thoracic muscles to re breathing. Respiratory muscles cramping shortening failing and shrinking. Pulling downward. Affecting neck shoulders chest and ribcage expansion back muscles. Inflammation of those tissues causing legs to buckle
No follow up on small hole found in throat from barium swallow. No follow up fractured thyroid cartilage last year. No one knows about completely cracked and perforation of the trachea from hyoid bone with infection or tumor scarring into tongue gums tonsils throat esophagus no one knows except dr Mallette.
Suspicious possible paraneoplastic syndromes which type. Mucosal skin spinal cord bones joints tendons muscles all affected, liver kidneys Throat stomach
High hgfactor 9.0 2018 Shoulder and blades tenosynovitis Possible portal hypertension ascites Umbilical hernia small Liver pain swelling dull sharp stiffness Servere herniation gastritis Esophageal erosion into Throat with infection or possible Cancer. See notes for symptoms. Heavy swollen limp belly pain and lumps under skin multiple. Server chronic gastric swelling burning massive lumps reflux and inflammation Chronic nasal narrowed tonsilar salivary gland lymph nodes swelling burning Chronic infections. Reactive lymphnodes swelling with pain and without chronically neck collar bone under jaw arm pits groin. Possible belly lumps under skin most noticeable nowadays Ear infections Chronic painful drooling can't move speak swallow cough clear Very much at mouth going numbness pain tingling burning fried Bone joint effusions. Spinal cord hypertrophy and subluxation multilevel central stenosis and dissection with spinal crepitus with serve pain amount other concerning findings.
Occipatal nerve pain radiation into neck SCM muscle swollen down into not belly into pelvis groin knees ankles feet with bladder loss and loss of sensation in small toes with burning Chronic swollen lymph nodes neck collar bones armpits groin other areas
Carb and sugars intolerance, grains Enzyme deficiency?
Infections past history: Stomatitis mucositis recent dr aktas Bartonella anaplasmosis highly suspected Lyme disease igx testing CLIA certified lab, fungal and bacterial skin and mouth constant bleeding and fluid filled blisters clear and sticky liKe lips and nose and skin when smoking.
lichens planus as per dr staple ford 2016. This I believe prednisone meds smoking makes worse. Infections and now covid positive april24.
Severe periodontal disease with chronic infections dr Nagle 2016. Severe bleeding gums infections all teeth cracked nerve roots exposed tightening cannot use gum tools to clean anymore my whole body ballistic from infections and pain just tongue tonsils salivary glands upper throat ears into esophagus out into my entire system. Systemic.
Dr Banner London.Dysautonomia, weak immune. Response overload zoonotic infections metal toxicity high
Dr Baker. London Lyme Bartonella rickesii and other zoonotic type infections.
Dr lemmo Windsor. Neurotoxicity autoimmunity or pathogen or a combination thereof all brain, CNS pons medulla mid brain right frontal lobe issues breathing swallowing Shrinkage of belly rectus ab wall diaphram breathing muscles not being used from brain.
Antibiotics: Flagyl tooth abcess still there never removed all teeth deterioration now bleeding Pennicylin bad reaction quad biopsy caused mouth droop and drooling most probable from Lyme and Bartonella Azithromicin suspected sinusitis Amoxicillin sinus infection Doxycycline destroyed me Bartonella Lyme Ciprofloxacin skin internal infection suspected staph for bacterial skin lesions on arms scalp legs shins. It worked but keeps coming back. Ceftriaxone suspected sinus throat stomach esophagus infection. Last Anti destroyed me.
Topical Bacterial and fungal chronic use. Keeps coming back bartonellosis Lyme, crackes perforated throat in throat thinning of veins?
Ssri history never agreed with not only he issue all gave serotonin syndrome. Again not the issue here celexa Zoloft. Made worse with Bartonella Lyme coinfections. Lorazapam for single muscle from infection 2.5 years ago with tramadol famotine. Can't get off pills. Just use for immune response. But making tissues and other things worse. Take 3 halves .05 every 6 hours. Body's used to it interacting with cigs see rest of notes.
All related to bacterial fungal infections all started with Bartonella Lyme, babesia anaplasma coinfections and most likely Covid sars worsening . Haven't stopped all.

Female 53 Non Smoker. Lynch Syndrome. No Cancer. Healthy. Dad died from Lung cancer a few months ago. His brother had lung cancer. Nodules removed. Is doing well.
I am a carrier for Anti Trypsin 1 deficiency.
I originally went in about a month ago to doctor to have an x-ray done because my clavicle seemed enlarged. After X-ray and a neck ultrasound they still couldn't figure out 100% if the enlargement was bone related or something else. A Few days ago I went to have a ct scan, and the radiologist that read my x-ray and ultrasound also read this image also. He stated I had a lymph nodes and so on.
Then a different radiologist stated something else. Both Radiologists from the same hospital. I'm really confused. The prominent clavicle issue is all set. Apparently I have scoliosis and that's why my collarbone is prominent. But the other issues I'm concerned with. Do you have any suggestions? Should I have another hospital read these? First reading: DIAGNOSTIC IMAGING REPORT
Some nonspecific lymphadenopathy identified in the mediastinum. No enlarged masses. A nonspecific supraclavicular lymph node on the right is identified. This is seen medially and just anterior to the right lobe of the thyroid. This measures 14 mm. This is identified on the right. Small submental lymph node measuring less than 5 mm is noted off to the left.
IMPRESSION: Prominence of the distal margin of the clavicles with degenerative spurring noted. Changes of what appear to be a slightly prominent right supraclavicular lymph node and a smaller lymph node on the left as well. Suggest further evaluation at some point with ultrasound and attention to the supraclavicular region to evaluate these lymph nodes and determine if they resolve. The one on the right is the largest at 1.36 cm, Small nonspecific mediastinal Iymph nodes are identified also.
The next interpretation:
ADDENDUM: Upon review of the CT examination it would appear that what is described as a right supraclavicular lymph node in actuality represents a seqment of asymmetrically prominent right internal jugular vein. Additionally, the patient has a mild proximal thoracic scoliotic curvature which most likely causes slight asymmetry in the thoracic cage whereby the right sternoclavicular joint is slightly more anterior than that of the left which is suspected to result in a probable mild asymmetric palpable abnormality. These findings were discussed with Dr.
Service Date: 02/03/22 Order#(s): 0203-0008 Reason: R22.2 LOCALIZED SWELLING, MASS AND LUMP, TRUNK 067 8 OTHER CONGENITAL DEFORMITIES OF CHEST CLINICAL HISTORY: Swelling, mass/lump in the trunk, deformity of the chest. PROCEDURE: Multiple axial images obtained without contrast enhancement. Coronal and sagittal reformatted view submitted.
AXILLARY REGIONS: Unromarkable. THORACIC AORTA: Unremarkable. PULMONARY OUTFLOW TRACT: Unremarkable. HEART/PERICARDIUM: Normal. LUNG PARENCHYMA: A few small nonspecific pulmonary nodules measuring less than 3 mm identified in both lung bases. Bony prominence of the distal margin of both clavicles, left slightly greater than right, There are no masses. No definite large soft tissue abnormality. Thyroid gland is intact. No mediastinal adenopathy. LIMITED UPPER ABDOMEN: No acute abnormality.
Please help. Thank you.

Axial CT imaging was performed from the skull base to the upper chest with 5 mm axial, sagittal and coronal reconstructions. 100 mL of Isovue 300 utilized for contrast enhancement. Area of interest is noted with Beekley spot marker.
CT imaging demonstrates normal symmetric parotid and submandibular salivary glands. There are sub-1 cm submental nodes noted. There are 2 adjacent lymph nodes just inferior to the right submandibular salivary gland at the area of interest. The largest measures 8 x 13 mm. Similar nodes are seen in the left submandibular neck with at least one node measuring 13 x 17 mm. No asymmetry of the adenoidal or tonsilar regions. There is no abnormality of the carotid neurovascular bundle on the right or left. There are no enlarged nodes in the anterior or posterior cervical chain. There is no abnormality of the nasopharynx or hypopharynx. The proximal trachea and proximal esophagus are unremarkable. There is no supraclavicular or superior mediastinal lymphadenopathy. There are normal symmetric thyroid glands. Bone windows do not demonstrate abnormality of the cervical spine.
RADIOLOGY RESULTS Impression 2 small adjacent lymph nodes are seen inferior to the right submandibular salivary gland in the area of interest. The largest measures 8 x 13 mm. Similar nodes are seen in the left submandibular neck with at least one node being enlarged measuring 13 x 17 mm. Bilateral anterior cervical chain nodes likely representing reactive nodes. Clinical correlation and follow-up as clinically indicated.