ENT Pathology III

Question 1

injury to vocal cord

Answer 1

rxn is vocal cord nodule and polyp

heavy smokers
recurrent voice strain

“singers nodules”

virtually never give rise to cancers

Question 2

nodules

Answer 2

bilateral and small

Question 3

polyp

Answer 3

unilateral and larger

Question 4

papillomatosis

Answer 4

multiple
-children

juvenile laryngeal papillomatosis

Question 5

papilloma

Answer 5

single
-adults

can be recurrent

Question 6

benign neoplasm on vocal cord

Answer 6

papilloma

single in adults
multiple in children

HPV causes

can develop dysplasia and malignancy

Question 7

prolonged hoarseness, dysphagia, palpable cervical lymph nodes, male, smoker, drinker,, 65-74yo

Answer 7

squamous cell carcinoma of larynx

Question 8

premalignant changes in invasive carcinoma

Answer 8

hyperplasia > hyperkeratosis > dysplasia > carcinoma in situ > cancer

Question 9

glottic carcinoma

Answer 9

involve true vocal cords

majority**

5 5yr survival 65%

Question 10

supraglottic carcinoma

Answer 10

laryngeal epiglottis, false vocal cords, laryngeal ventricles

often discovered late - later stage

5 yr survival 45%

Question 11

subclottic carcinoma

Answer 11

more than 10mm below free margin of true vocal cords up to inferior border of cricoid cartilage

Question 12

transglottic carcinoma

Answer 12

involve true and false vocal cords

worst prognosis

Question 13

squamous cell carcinoma of larynx

Answer 13

intrinsic - confined to larynx

extrinsic - beyond the larynx

Question 14

stage 4

Answer 14

distal metastasis

Question 15

stage 1

Answer 15

localized tumor

Question 16

marked tenderness after traction of ear

Answer 16

otitis externa

7-12yo

swimmers ear

Question 17

common cause of otitis externa

Answer 17

bacterial

-pseudomonas

Question 18

middle ear

Answer 18

non-keratinizing stratified squamous epithelium

Question 19

cholesteatoma

Answer 19

squamous epithlieum trapped within temporal bone
-middle ear or mastoid

can rupture and erode to bone

hearing loss, facial nerve paralysis, labrynthitis, meningitis, epidural or brain abscess

Tx - surgical resection

Question 20

tympanic membrane opacity, bulging, erythema

Answer 20

acute otitis media

Question 21

causes of acute otitis media

Answer 21

bacteria - most common

s. pneumoniae, haem influenza, moraxella catarrhalis

Question 22

chronic otitis media

Answer 22

eustachian tubes blocked repeatedly

pseudomonas aeruginosa

conductive hearing loss

Question 23

otosclerosis

Answer 23

fibrosis and thickening of tissue around eardrum

dystrophic calcification

hear less and less and less

family hx of hearing loss

Question 24

branchial cleft defect

Answer 24

masses on lateral neck

Question 25

thyroglossal duct cyst

Answer 25

midline -<40yo behind sternum up to tongue ectopic thyroid tissue

Question 26

carotid body tumor

Answer 26

PS tumor -increase RR and hypoxia bruit on auscultation recurs with incomplete resection familial cases - MEN type 2 many metastasis slow growing, painless, pulsatile