Ch 9.1-9.2, 18.4-18.5, 10.1-10.2 Pathoma; Resp, MSK, GI Flashcards
Name 4 pathologies seen in the nasopharynx
rhinitis, nasal polyps, angiofibroma, nasopharyngeal carcinoma
Rhinitis is inflammation of the ___. ___ is the most common cause. It presents with ___, ___, and ___ (common cold).
nasal mucosa (respiratory epithelium); Rhinovirus (or adenovirus?); sneezing, congestion, runny nose
Allergic rhinitis is a subtype of rhinitis due to type __ hypersensitivity (ex: rxn to ___). It is characterized by a ____ infiltrate with ___. It is associated with ___ and ____.
1; pollen; inflammatory; eosinophils; asthma; eczema
____ is a protrusion of edematous, inflamed nasal mucosa, usually secondary to repeated bouts of ____.
Nasal polyp; rhinitis
In addition to rhinitis, nasal polyps also occur in these two other situations.
Cystic fibrosis (if you have a child with nasal polyps, think CF); aspirin-intolerant asthma
Aspirin intolerant asthma is characterized by this triad. It is seen in __% of asthmatic adults
asthma; aspirin-induced bronchospasms; nasal polyps; 10
Angiofibroma is a malignant/benign tumor of nasal mucosa composed of ___ and ___. It is classically seen in ___. It presents with profuse ___.
benign; large blood vessels; fibrous tissue; adolescent males; epistaxis
____ is a malignant tumor of nasopharyngeal epithelium. It is associated with ___, and classically seen in ___ and ___.
Nasopharyngeal carcinoma; EBV; Chinese adults; African children
Nasopharyngeal carcinoma biopsy reveals pleomorphic ___+ ____ cells (poorly differentiated ____) in a background of ____. It presents with involvement of ____.
keratin; epithelial; squamous cell carcinoma; lymphocytes (keratin helps reveal there are epithelial cells); cervical lymph nodes
Name 5 pathologies of the larynx
acute epiglottitis; laryngotracheobronchitis (croup); vocal cord nodule (singer’s nodule); laryngeal papilloma; laryngeal carcinoma
Acute epiglottitis is ___ of the epiglottis. ___ is the most common cause in both immunized and especially non-immunized children.
inflammation; H influenza type b
Acute epiglottitis presents with these 5 symptoms and has a risk of ___.
1) high fever; 2) sore throat; 3) drooling with dysphagia; 4) muffled voice; 5) inspiratory stridor; airway obstruction (medical emergency)
Laryngotracheobronchitis (aka ___), is inflammation of the ___. ___ is the most common cause. It presents with a hoarse, “___” cough, and ____.
croup; upper airway; parainfluenza virus; barking; inspiratory stridor
Vocal cord nodule (aka ___) is a nodule that arises on the true/false vocal cord. It is due to ___, and is usually unilateral/bilateral. It is composed of ____ tissue, and presents with ___. Resolves with resting of the voice.
Singer’s nodule; true; excessive use; bilateral; degenerative (myxoid) connective tissue; hoarseness
Laryngeal papilloma is a malignant/benign papillary tumor of the ___. It is due to ___. Papillomas are usually single in adults/children and multiple in adults/children. It presents with ___.
benign; vocal cord; HPV 6 and 11; adults; children; hoarseness
Laryngeal carcinoma is a ___ carcinoma arising from the ___ lining of the ___. It presents with ____. Other signs include __ and __.
squamous cell; epithelial; vocal cord; hoarseness; cough; stridor
Name two big risk factors for laryngeal carcinoma. Name an additional.
alcohol and tobacoo; can rarely arise from a laryngeal papilloma
Dermatomyositis is an inflammatory disorder of the __ and ___. The etiology is ___. Some cases are associated with ____ (ex: ___). Treatment is ____.
skin; skeletal muscle; unknown; carcinoma; gastric carcinoma; corticosteroids
Name 3 clinical features of dermatomyositis
1) bilateral proximal muscle weakness (distal invlvmt late in dx); 2) rash of upper eyelids (heliotrope rash) and malar rash; 3) red papules on elbows, knuckles, and knees (Gottron papules)
Name 3 lab findings and the bx finding in dermatomyositis
1) increased creatine kinase; 2) positive ANA; 3) positive anti-Jo-1 antibody; 1) perimysial inflammation (CD4+ T cells) with perifascicular atrophy on bx
Which skeletal muscle inflammatory disorder involves the endomysium vs perimysium? Which T cells are involved in each?
Polymyositis: endomysium CD8+ t cells
Dermatomyositis: perimysium CD4+ t cells
Polymyositis is an inflammatory disorder of ____. It resembles ____ clinically (___ muscle weakness), but ___ is not involved. ____ inflammation (CD__ t cells) with ___ muscle fibers is seen on biopsy
skeletal muscle; dermatomyositis; proximal; skin; endomysial; CD8+; necrotic
Muscular dystrophy is a degernative disorder characterized by ___ and replacement of ___ by ___. Name the pattern of inheritance. It is due to defects of ___ gene, which is impt for ___ the muscle ___ to the___. Mutations are often ___, since the large gene size predisposes to high rates of mutation
muscle wasting; skeletal muscle; adipose tissue; x-linked recessive; dystrophin; anchoring; cytoskeleton; extracellular matrix; spontaneous
Duchenne muscular dystrophy is due to a deletion/mutation of ____. It presents as proximal/distal muscle weakness at __ years of age. Progresses to involve ___ muscles. Death results from __ or __ failure. ___ is commonly involved.
deletion; dystrophin; proximal; 1; distal; respiratory; cardiac; myocardium
Name 1 clinical characteristic finding of DMD, and 1 lab finding. Becker muscular dystrophy is due to ___. Clinically results in milder/more severe disease.
calf pseudohypertrophy (distal muscle that pt initially puts weight on, since proximal are first - causes hypertrophy, then it turns to fat); elevated serum creatine kinase; mutated dystrophin; milder
Myasthenia gravis is due to ___ again the pre/post synaptic ___ receptor at the NMJ. It is more commonly seen in women/men. Symptoms improve with ___ agents.
autoantibodies; post; acetylcholine; women; anti-cholinesterase (acetylcholinesterase inhibitors)
Myasthenia gravis presents with ___ that improves/worsens with use and improves/worsens with rest. It classically involves the ___, leading to __ and __. It is associated with ___ or ___, so a ___ improves symptoms.
muscle weakness; worsens; improves; eyes; ptosis; diplopia; thymic hyperplasia; thymoma; thymectomy
Lambert-eaton syndrome is due to ___ against pre/post synaptic ____ of the NMJ. It arises as a ___ syndrome, most commonly due to ___. It leads to impaired ___ release, since firing of ___ is required for ___ release.
antibodies; pre; calcium channels; paraneoplastic; small cell carcinoma of the lung; acetylcholine; presynaptic calcium channels; acetylcholine
Lambert-eaton syndrome symptoms do/do not improve with anti-cholinesterase agents. It resolves with ___. It causes proximal/distal muscle weakness that improves/worsens with use. ___ are usually spared.
do not; resection of the cancer; proximal; improves (more use creates a stronger calcium gradient to knock off the antibody); eyes
Myasthenia gravis vs. lambert eaton syndrome: which gets better with use, and which responds to acetylcholinesterase inhibitors?
Lambert-eaton syndrome; myasthenia gravis
Cleft lip and palate is a full/partial thickness defect of lip and palate. It is due to failure of ____ to ___ . They usually occur together/separately. During early/late pregnancy, ____ (one from superior, two from the sides and two from inferior) grow and ___ together to form the face.
full; facial prominences; fuse; together (isolated cleft lip or palate is less common); early; facial prominences; fuse
An aphthous ulcer is a painless/painful, ____ ulceration of the ____. It arises in relation to ___ and resolves spontaneously, and never/sometimes/often recurs. It is characterized by a ___ base surrounded by ___.
painful; superficial; oral mucosa; stress; often; grayish (represents granulation tissue); erythema
Behcet syndrome is recurrent ___, ___, and ___. It is due to ____ involving small ____. Can be seen after ___ infection, but etiology is ____.
aphthous ulcers; genital ulcers; uveitis; immune complex vasculitis (type 3 hypersens); vessels; viral; unknown
Oral herpes are ___ involving oral ___ that rupture, resulting in shallow/deep, painless/painful, ___ ___. Usually due to ____. Primary infection occurs in ___. Lesion heal, but virus remains dormant in ____. ___ and ___ cause reactivation of the virus, leading to ___ that often arise on the lips (aka ___)
vesicles; mucosa; shallow, painful, red ulcers; HSV-1; childhood; ganglia of trigeminal nerve; stress; sunlight; vesicles; cold sores
Squamous cell carcinoma of the oral mucosa is most commonly found in the ___. ___ and ___ are the major risk factors. ___ and ___ are common precursor lesions.
floor of the mouth; tobacco; alcohol; oral leukoplakia and erythroplakia
Oral leukoplakia is a ___ that can/cannot be scraped away. It often represents ____. It can be mistaken for ___ and ___. It is often ___ to rule out carcinoma.
white plaque; cannot; squamous cell dysplasia; oral candidiasis; hairy leukoplakia; biopsied
Oral erythroplakia is a ___ that represents ____ leukoplakia and is highly suggestive of ___. It is often ___ to rule out carcinoma.
red plaque; vascularized (angiogenesis due to dysplasia); squamous cell dysplasia; biopsied
Is oral leukoplakia or erythroplakia more suggestive of squamous cell dysplasia?
erythroplakia (there is angiogenesis suggestive of dysplasia)
Oral candidiasis is a ___ on the tongue, which can/cannot be scraped away. It is usually seen in ___ patients. Hairy leukoplakia is a ___, ___, ___ patch that arises on the __ tongue. It is usually seen in __ patients, and is due to ___-induced squamous cell ___. It is/is not pre-malignant.
white deposit (thrush); can (easily); immunocompromised; white, rough, hairy; lateral; immunocompromised; EBV; hyperplasia (no dysplasia); is not
Salivary glands are ___ glands that secrete ___. They are divided into major (name 3) and minor glands (hundreds of microscopic glands distributed throughout the ___)
exocrine; saliva; parotid, submandibular, sublingual; oral mucosa
Mumps infection (virus) can result in unilateral/bilateral inflamed ___ glands. These 3 other conditions may also be present. Serum amylase may be increased due to ___ or ___ involvement. ___ carries the risk of sterility, especially in children/teenagers/adults
bilateral; parotid; orchitis; pancreatitis; aseptic meningitis; salivary gland; pancreatic; orchitis; teenagers (less than 10 don’t get orchitis)
____ is inflammation of the salivary gland. Most commonly due to a _____ (aka ____) leading to ___ infection. Usually unilateral/bilateral.
Sialadenitis; obstructing stone; sialolithiasis; staph aureus; unilateral
Pleomorphic adenoma is a benign/malignant tumor composed of ___ and ___ tissue. Usually arises in ___ gland. Presents as mobile/non-mobile, painless/painful, ___ mass at the ____. There is a high/low rate of recurrence. Extension of small islands of tumor through tumor capsule often leads to ___. Salivary gland
benign; stromal (eg cartilage); epithelial; parotid; mobile, painless, circumscribed; angle of the jaw; high; incomplete resection
Most common salivary gland tumor
What is the most common tumor of the salivary gland? What is the 2nd most common? What is the most common malignant tumor of the salivary gland?
pleomorphic adenoma; warthin tumor; mucoepidermoid carcinoma
Pleomorphic adenoma often/sometimes/rarely/never transforms into carcinoma, which presents with signs of ___ damage, since the ___ runs through the ___ gland.
rarely; facial nerve; facial nerve; parotid
Warthin tumor is a benign/malignant ___ tumor with abundant ___ and ____ (___-like stroma). It is the 2nd most common salivary gland tumor. It almost always arises in the ___ gland.
benign; cystic; lymphocytes; germinal centers; lymph node; parotid
cystic tumor w/LN tissue
Name 3 tumors of the salivary gland and which ones are benign vs malignant
pleomorphic adenoma (benign); warthin tumor (benign); mucoepidermoid carcinoma (malignant)
Mucoepidermoid carcinoma is a benign/malignant tumor composed of ___ and ___ cells. It is the most common malignant tumor of the salivary gland. Usually arises in the ____, and commonly involves the ___.
malignant; mucinous; squamous; parotid; facial nerve
