Ch 16 Flashcards
What are the most common organisms causing rhinitis?
Adenovirus
Rhinovirus
Echovirus
What are the major nasal findings in rhinitis?
Thickened, edematous, red nasal mucosa
Enlarged turbinates
What separates allergic rhinitis from infectious rhinitis?
Presence of eosinophilia
Recurrent attacks of rhinitis can cause ___?
Nasal polyps
Histology = edematous mucosa with loose stroma containing hyperplastic/cystic mucosal glands
Nasal polyp
If a child has a nasal polyp, what congenital disease should you think of?
Cystic Fibrosis
Histology = superficial desquamation/ulceration of mucosal epithelium with abundance of neutrophils
Chronic rhinitis
What are the most common offending agents of sinusitis?
Inhabitants of the oral cavity
What pathology is caused by impaired drainage of a sinus by inflammation?
Sinusitis
If the blockage of a sinus is complete, not allowing the exudate to escape, what can form?
Empyema
Chronic sinusitis associate with DM is most often caused by what organism?
Mucormycosis
Which organisms are most likely to cause necrotizing lesions of the nose and upper airway?
Candida, Mucor, Aspergillus
What type of pts are most at risk for necrotizing lesions of the nose and upper airway?
Immunosupressed with DM
What disease is associated with a presentation of non-healing ulcers around the nasopharynx?
Granulomatosis with Polyangiitis
Which Ab is found in Granulomatosis with Polyangiitis?
PR3-ANCA
What is the triad of Sx’s for Granulomatosis with Polyangiitis?
Necrotizing granulomas of URT/LRT, vessels, and glomerulus
What are the most common organisms to cause pharyngitis or laryngitis?
Adenovirus, Rhinovirus, Echovirus
Sx’s = reddening/edema of nasopharyngeal mucosa with enlargement of tonsils and LN’s
Pharyngitis/Laryngitis
If a bacterial infection is superimposed on pharyngitis/laryngitis, what are the most common type?
ß-hemolytic strep
S. Aureus
Benign, vascular tumor seen in adolescent males with fair skin and red hair
Nasopharyngeal Angiofibroma
What cancer is associated with FAP?
Nasopharyngeal Angiofibroma
Where do Nasopharyngeal Angiofibromas arise?
Roof of nasal cavity
Benign tumor from respiratory mucosa lining the nasal cavity and paranasal sinuses
Sinonasal Papilloma
Which type of Sinonasal Papilloma is most aggressive and arises in men 30-60 yo
Endophytic/Inverted
What is a potential complication of Sinonasal Papilloma’s?
Invasion into the orbit or cranial vault
Tumor arising from neuroectodermal olfactory cells in the superior aspect of the nasal cavity
Olfactory Neuroblastoma
Pts present with nasal obstruction and epistaxis around 15 or 50 yo
Olfactory Neuroblastoma
Histology = small, blue, round cell neoplasms made of nests/lobules of well-circumscribed cells separated by fibrovascular stroma
Olfactory Neuroblastoma
Olfactory Neuroblastomas will stain + for ___?
Chromogranin, Synaptophysin, CD56
Tumor that may occur in nasopharynx, salivary glands, or other midline structures due to creation of BRD4-NUT fusion gene
NUT Midline Carcinoma
Tumor associated with lymphoid tissue or EBV with nasal obstruction, epistaxis, metastases to cervical LNs
Nasopharyngeal Carcinoma
In what populations are Nasopharyngeal Carcinomas most common?
Africa = children China = adults
Histology = epithelial cells with oval/round nuclei and indistinct cell borders creating syncytium-like array
Nasopharyngeal Carcinoma
EBER-1 and LMP-1 detected
Nasopharyngeal Carcinoma
What are the most common organisms responsible for laryngeal inflammation in children?
RSV, H. Influenzae, ß-hemolytic strep
Where do vocal cord nodules appear?
Singers nodules = bilateral
Polyps = unilateral
If you see peritonsilar abscesses, what organism should you think?
Strep
Sx = change of voice and progressive hoarseness
Reactive nodules
Smooth, raspberry-like proliferations on the true vocal cords
Squamous papilloma
Recurring papillomas in adulthood are often due to ___?
HPV type 6 and 11
What type of cancer makes up over 95% of laryngeal cancers?
SCC
Histology = pearly gray, wrinkled plaques on mucosal surface that ulcerate and fungate
Carcinoma of the larynx (SCC)
What is the common presentation, age, and sex for Carcinoma of the larynx (SCC)?
Sx = hoarseness, dysphagia, dysphonia
men, > 60 yo
If smoking ceases prior to dysplasia of the epithelium in the larynx, what happens?
Regression occurs
What are the most common bacteria causing ear infections?
S. Pneumoniae, Non-typeable H. Influenzae, M. Catarrhalis
What are the most common causes of chronic otitis?
Pseudomonas, S. Aureus, Fungi
What organisms cause Bullous Myringitis?
S. Pneumoniae, M. Pneumoniae
Histology = Non-neoplastic cystic lesion lined by keratinizing squamous epithelium and filled with amorphous debris
Cholesteatoma
What are Cholesteatomas associated with?
Otitis media
Invasion into adjacent structures
Carcinomas of the ear occur in what population and because of what?
Elderly men
Sun exposure
Suppurative destruction of the lung parenchyma with a central area of cavitation
Lung abscess
