ENT: Head and Neck path

Question 0

What are two major symptoms of patients with neck cancers?

Answer 0

1. Hoarseness of greater than 3 weeks duration

2. Unexplained dysphasia greater than 3 weeks duration

Question 1

What is most commonly found in the history of a patient that develops cancerous lesions in the head and neck?

Answer 1

Tobacco and/or alcohol abuse

Question 2

How can leukoplakia be differentiated from thrush?

Answer 2

Leukoplakia cannot be scraped off without bleeding, whereas the fungus can.

Question 3

What needs to be done with leukoplakia or erythroplakia that persists greater than 3 weeks?

Answer 3

Biopsy:

• leuko has 5% chance of progression to cancer
• erythro has 25-75% chance of progression to cancer

Question 4

Most common head and neck cancer.

Answer 4

Squamous Cell Carcinoma

Question 5

Most common site of Basal Cell Carcinoma in the head and neck.

Answer 5

Upper Lip

Question 6

Infectious agent associated with oropharynx squamous cell carcinoma.

Answer 6

Human Papilloma Virus

Question 7

Serotypes of HPV that are associated with highest incidence of causing oropharyngeal cancer.

Answer 7

16 and 18

Question 8

HPV causes cancer by affecting two proteins. Name them and the two genes that each influences.

Answer 8

1. E6: decreases p53 activity

2. E7: decreases RB activity