2nd Exam: Head and Neck Disease

Question 1

Abnormal positions of head:

Answer 1

kyphosis, torticollis

Question 2

Kyphosis:

Answer 2

usually spine disease, forward bending of neck

Question 3

Torticollis:

Answer 3

twisting, congenital, antipsychotics, infections in neck or pharynx, spastic - abnormal contration of cervical mm. (often neurologic d., muscle relaxant), can be oscilating, head continually moving

Question 4

Most hearing problems involve:

Answer 4

middle ear, disease of oscicles

Question 5

Middle ear issue related to the base/footplate of the stapes:

Answer 5

otosclerosis: fibrous ankylosis (stiffness/ fusion of joint) ossicles, calcification, deformity, dysfunction, often not severe loss, conductive, oft autosomal dominant, slow progression, usually middle age

Question 6

2 types of hearing loss:

Answer 6

sensory (nerve deafness, inner ear) and conductive (bones, middle ear)

Question 7

Common ear issue in kids:

Answer 7

Otitis media, preceding URI (i.e., cold), blocked eustachian tube

Question 8

Eustachian tube communicates bw:

Answer 8

middle ear, oral cavity

Question 9

Where does otitis media usually start?

Answer 9

mouth/ nose

Question 10

Acute otitis media:

Answer 10

bacterial, middle ear fills w pus, pain from pressure and inflammation

Question 11

treatment for otitis media:

Answer 11

Antibiotics, gone in a few days

Question 12

Sinusitis:

Answer 12

usually bacterial, common, headache, fever, face pain (maybe teeth), thick, purulent nasal discharge, bad breath

Question 13

Causes of acute sinusitis:

Answer 13

HIMSP: H influenze, Moraxella, strep pnemoniae

Question 14

Suspect this is pt has tooth pain, headache, fever, and purulent discharge:

Answer 14

sinusitis, referred from sinus

Question 15

Cause of halitosis in sinusitis:

Answer 15

bacteria, smell changes w bacteria type

Question 16

Normal sinuses are lined by

Answer 16

pseudostratified ciliated columnar, w goblet cells

Question 17

Resp epi is:

Answer 17

stratified epithelium

Question 18

Pathology of sinusitis:

Answer 18

obstruction of ostia, URI, allergic rhinitis, oral infection, usually tooth

Question 19

ostia:

Answer 19

opening at end of canal

Question 20

Sinusitis sinus staining:

Answer 20

blue, viscous secretion that gets infected

Question 21

Appearance of mucosal inflammation in sinusitis on slides:

Answer 21

lots of blue PMNs surrouned by white

Question 22

Does the sinus mucosa make mucoid secretions?

Answer 22

yes

Question 23

Nasal polyps:

Answer 23

assoc w chronic rhinitis, not allergic, reactive, non-neoplastic, bleeding, sneezing, difficulty breathing, tend to enlarge, edematous, gelatinous, tan-pink, inflamed

Question 24

TF? Nasal polyps are caused by allergy.

Answer 24

F

Question 25

What induces the reactive change in nasal polyps?

Answer 25

inflammation

Question 26

Are nasal polyps typically singular or mulitple?

Answer 26

multiple

Question 27

Nasal polyps may also affect:

Answer 27

paranasal sinus

Question 28

What proliferates in nasal polyps?

Answer 28

stromal and epi cells

Question 29

Type or proliferation nasal polyps are:

Answer 29

mucosal

Question 30

Cellular components of nasal polyps:

Answer 30

stroma under, ct core, often inflammed, collagen, inflammatory cells, mesenchymal elements

Question 31

Olfactory neuroblastoma:

Answer 31

malignant, from sup pos nasal cavity, origin: olfactory epi, primitive, undifferentiated, usually 55yo, nasal discharge, stuffiness, epitaxis (bleeding), obstruction, 75% 5 y survival rate, small, round blue (nuclie) cells, nests surrounded by fibrous stroma

Question 32

Rx for olfactory neuroblastoma:

Answer 32

surgery + radiation

Question 33

Olfactory neuroblastoma, benign or malignant?

Answer 33

malignant

Question 34

Glands of olfactory epi:

Answer 34

Bowman’s glands

Question 35

Olfactory n. fibers cross this before entering the olfactory epi:

Answer 35

lamina propria

Question 36

Cells at the lamina propria surface of olfactory epi:

Answer 36

basal cells

Question 37

Composition of olfactory neuroblastoma:

Answer 37

supporting tissue, mesenchymal tissue and collagen

Question 38

Danger of olfactory neuroblastoma:

Answer 38

invasion of surrounding structures, brain

Question 39

S100 protein is a protein marker for:

Answer 39

neural cells

Question 40

Micro view of olfactory neuroblastoma:

Answer 40

Homer-Wright rosettes-tumor cells around central focus of fibrillary material

Question 41

Nestles in images are characteristic of:

Answer 41

olfactory neuroblastoma

Question 42

olfactory neuroblastoma can appear to be

Answer 42

lymphoma, S100 protein stain to rule out lymphoma

Question 43

Tumor of neural origin:

Answer 43

olfactory neuroblastoma

Question 44

Reasons for hoarse voice:

Answer 44

singer’s node, R/O laryngeal cancer, URI, benign reactive lesion, arise from vocal cords, usually singuar

Question 45

Singer’s nodes are typically found here;

Answer 45

anterior vocal cord, few mm

Question 46

Singer’s node:

Answer 46

polypoid lesion, hyperplastic epi, stroma with edema, prominent vessels and inflammation, reactive looking, similar to nasal polyps, project into larynx

Question 47

Causes of coughing:

Answer 47

usually upper respiratory, often in bronchii, laryngitis, bronchitis, pneumonia

Question 48

Causes of laryngitis:

Answer 48

tobacco smoke, acid reflux, singing, allergy, usually part of URI, viral, bacterial

Question 49

2 types of acute bronchitits:

Answer 49

infection (usaully viral, bacterial), whooping cough

Question 50

Examples of viral infetions that can cause acute bronchitis:

Answer 50

flu, adenovirus

Question 51

Whooping cough;

Answer 51

pertusis, gram negative, ro, exotoxin, highly contageous, usually unvaccinated kids, -4wks, fever, rhinitis, sneezing prodrome, violent cough, vomiting due to GI iritation, dehydration

Question 52

whooping cough can develop into:

Answer 52

acute bronchitis, exudate in lumen, can infect you