9.1, 9.2 Nasopharynx, Larynx

Question 1

acute epiglottitis

• most common cause
• why is this a medical emergency

Answer 1

• H influenzae type B, most cause in both immunized and non-immunized children
• risk of airway obstruction

Question 1

Vocal cord nodule

• cause
• composition (histology)
• tx

Answer 1

• excessive use
• degenerative (myxoid) connective tissue
• rest the voice

Question 2

laryngeal carcinoma

• what is it
• risk factors (2)

Answer 2

• squamous cell carcinoma usu on vocal cord
  1. smoking
  2. alcohol
• can rarely arise from laryngeal papilloma

Question 3

allergic rhinitis:

• mech
• what assoc with
• characterized by what blood cells

Answer 3

• Type I HSR
• asthma, eczema
• eosinophils

Question 4

laryngeal papilloma

• what is it
• cause
• presentation

Answer 4

• benign papillary tumor of vocal cord
• HPV 6 and 11
• voice hoarseness

Question 5

nasopharyngeal carcinoma

-what does biopsy show?

Answer 5

• pleomorphic keratin-positive epithelial cells in background of lymphocytes
• keratin test is performed to make sure cells are epithelial, since they are hard to see in lymphocyte background

Question 7

most common microbe in rhinitis

Answer 7

rhinovirus

Question 7

child with nasal polyps:

suspect what?

Answer 7

test for Cystic fibrosis!

also consider aspirin-intolerant asthma

Question 8

nasopharyngeal carcinoma

-characteristic symptom

Answer 8

often presents with cervical adenopathy

Question 9

Laryngotracheobronchitis (Croup)

-how presents?

Answer 9

“Croup”

• inflammation of upper airway
  1. hoarse, ‘barking’ cough
  2. inspiratory stridor

Question 10

laryngeal papilloma

-what to see on histology?

Answer 10

-caused by HPV 6 and 11, so you’ll see koilocytes (epithelial cells that have changed appearance b/c of HPV virus)

Question 11

Nasal polyp:

• most common cause
• other important causes (2)

Answer 11

• usu 2ndary to repeated rhinitis
• also: cystic fibrosis, aspirin-intolerant asthma

Question 13

angiofibroma

• what is it
• presentation
• classic population

Answer 13

• benign tumor of vessels and fibrous tissue, found in nasopharynx
• presents as profuse epistaxis
• classic: adolescent male

Question 14

laryngeal papilloma

-how does presentation differ btwn adults and children?

Answer 14

adults: sinlge
children: multiple

Question 15

nasopharyngeal carcinoma

-classic populations (2)

Answer 15

• carcinoma of nasopharyngeal epithelium
  1. chinese young adults
  2. African children

Question 16

nasopharyngeal carcinoma

-assoc with what microbe?

Answer 16

EBV

Question 17

Laryngotracheobronchitis (Croup)

-most common cause

Answer 17

-parainfluenza virus

Question 18

Chinese adult with cervical adenopathy, biopsy shows pleomorphic keratin-positive cells.

-what is this?

Answer 18

nasopharyngeal carcinoma

Question 19

aspirin-intolerant asthma:

• how presents?
• what % of asthmatics?

Answer 19

triad:

1. asthma
2. aspirin-induced bronchospasms
3. nasal polyps
   - 10% of asthmatic adults

Question 20

Adolescent male with profuse epistaxis:

-suspect what?

Answer 20

• angiofibroma
• benign tumor, classically seen in adolescent males