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2 ENT > ENT Pathology > Flashcards

ENT Pathology Flashcards

1
Q

what is the external auditory meatus and external ear lined with

A

epidermis (skin)

has hair follicles, sebaceous glands and ceruminos glands

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2
Q

what is the middle ear lines with

A

columnar lined mucosa

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3
Q

what lines the nasal vestibule

A

squamous cell epithelium

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4
Q

what lines the nose and sinuses

A

respiratory epithelium (pseudo stratified ciliated columnar)

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5
Q

what lines the throat

A

respiratory and squamous epithelium depending on anatomical site

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6
Q

what type of glands are salivary glands

A

exocrine glands

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7
Q

what 2 components do salivary glands have

A

acinar component

ductular component

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8
Q

what kinds of cells are sound in salivary glands

A

serous cells
mutinous cells
peripheral myoepithelial cells

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9
Q

what are some common ear pathologies

A

otitis media
cholesteatoma
tumours
vestibular schwannoma

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10
Q

what is Ottis media

A

inflammation of the middle ear usually due to a viral infection, but can occasionally be bacterial

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11
Q

what is a cholesteatoma

A

a cysts/skin growth which develops in the middle ear secondary to chronic otitis media and a perforated tympanic membrane

has a high cell turnover and abundant keratin which leads to inflammation

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12
Q

what cell lining changes are seen in cholesteatoma

A

normal lining of middle ear is cuboidal or columnar glandular epithelium

cholesteatoms causes abnormally situated squamous epithelium

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13
Q

what is a vestibular schwannoma

A

a benign tumour of the myelin cells of the vestibular portion of the vestibulocochlear nerve

(tumour of Schwann cells)

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14
Q

what do bilateral vestibular schwannomas in your people suggest

A

Neurofibromatosis type 2

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15
Q

signs/symptoms of neurofibromatosis type 1

A 
neurofibromas 
bilateral vestibular schwannoma 
multiple meningiomas 
gliomas 
cafe au lait
cataracts
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16
Q

common nose pathologies

A 
rhinitis 
sinusitis
polyps 
Granulomatosis with polyangitis
tumours
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17
Q

what causes rhinitis and sinusitis

A

infections - common cold

allergies - hayfever, IgE mediated type 1 hypersensitivity reaction

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18
Q

what are nasal polyps

A

painless soft growth inside the nose

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19
Q

causes of nasal polyps

A 
allergy 
infection 
asthma 
aspirin sensitivity 
nickel exposure

if in young consider cystic fibrosis

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20
Q

what is granulomatosis with polyangitis

A

autoimmune disorder causing small vessel vasculitis and necrosis

usually limited to the resp tract and kidneys

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21
Q

how does granulomatosis with polyangitis present

A

pulmonary, renal disease or nasal symptoms of congestion

septal perforation

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22
Q

what are some charactersistics of granulomatosis with polyangitis

A

high frequency of anti-neutrophil antibody levels (ANCA +ve)

cANCA (GPA) (C and G look kinda similar lol)

23
Q

what tumours affect the nose

A

benign lesions (squamous papillomas, angiofibromas, schneiderian papillomas)

malignancy lesions (SCC)

primary adenocarcinoma, nasopharyngeal carcinoma, neuroblastoma, lymphoma

24
Q

what are schneiderian papillomas

A

benign tumours however can be locally destructive

can be inverted, exophytic or oncoytic

25
Q

who gets chneiderian papillomas

A

most common in males >50

risks 
HIV
Smoking 
organic solvents
welding
26
Q

what virus has a strong association with nasopharyngeal carcinomas

A

Epstein Barr virus

27
Q

who is most likely to get a nasopharyngeal carcinoma

A

males>females

more common in the Far East

28
Q

how can Epstein Barr predispose to carcinogens

A

it hi-jacks and mimics helper T cells

somehow it leads to the promotion of cells from G0 to G1

29
Q

common throat pathologies

A 
laryngeal polyps/nodules
ulcers
papillomas
dysplasia/cancer
paraganglioma
30
Q

what are laryngeal polyps

A

abnormal tissue growth secondary to vocal cause, infection and smoking

31
Q

what is a contact ulcer

A

a benign response to injury

occurs posterior to local cord

32
Q

what can cause a contact ulcer

A

chronic throat clearing
voice abuse
gastrooesophageal reflux
intubation

33
Q

what are squamous papillomas

A

common benign neoplasm of oral mucosa

34
Q

who gets squamous papillomas

A

two peaks of incidence >5 and 20-40 years

related to HPV types 6 and 11

aggressive in children but often solitary in adults

35
Q

what are paragangliomas

A

tumours arising from clusters of neuroendocrine cells

rare, can arise at any age but usually >50

can occur as part of MEN2

36
Q

what are squamous cell carcinomas

A

common tumour in head and neck (nose, sinuses, pharynx, larynx and oral cavity)

37
Q

risk factors for squamous cell carcinomas

A

smoking and alcohol

HPV

38
Q

how can HPV16 cause squamous cell carcinomas

A

produces proteins which disrupt p53 and RB pathways stopping cell regulation

39
Q

management for squamous cell carcinomas

A 
confirm diagnosis
grade
stage 
look at other prognostic factors 
(vascular invasion, perineurial invasion)
40
Q

what does T1a mean in SCC staging

A

affects one vocal cord

41
Q

T1b

A

affects both vocal cords

42
Q

T2

A

extension into supra/subglottis

43
Q

T3

A

vocal cord fixation or extension into paraglottic space minor thyroid cartilage involvement

44
Q

T4a

A

thyroid cartilage, trachea, muscles of tongue, strap muscles, thyroid, oesophagus

45
Q

T4b

A

prevertebral space, mediastinal structures, carotid artery

46
Q

what are the 4 main salivary glands

A

parotid
submandibular
sublingual
minor salivary glands

47
Q

what are sialolithiasis

A

calcified mass/stone forms int h salivary gland

48
Q

what are some common infections of the salivary glands

A

paramyxovirus (mumps)

49
Q

what is the most common site for all salivary gland tumours

A

parotid gland

50
Q

what are tumours in smaller salivary glands likely to be

A

malignant

51
Q

what is a pleomorphic adenoma

A

most common salivary gland tumour (benign)
usually seen in females 40-60 in the parotid gland

often recurrent and difficult to excise

52
Q

what is warthog’s tumour

A

2nd most common benign salivary gland tumour

males >50

usually in parotid

strong association with smoking

53
Q

what is the most common malignant salivary gland tumour

A

mucoepidermoid carcinoma (worldwide)

in uk its adenoid cystic carcinoma

54
Q

who gets adenoid cystic carcinomas

A

usually >40 an din the parotid gland, but also most common tumour of the palate

35% 5 year survival

2 ENT (15 decks)

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