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Pathology II > EXAM 1 Head and Neck > Flashcards

EXAM 1 Head and Neck Flashcards

1
Q

What is the lay person’s name for Infectious rhinitis?

A

common cold

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2
Q

What are common causes of infectious rhinitis?

A

Adenovirus, echovirus, rhinovirus

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3
Q

What are some sign and symptoms of acute stage of infectious rhinitis?

A
  • nasal mucosa is thickened, edematous, red
  • nasal cavities are narrowed
  • turbinates are enlarged
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4
Q

What can infectious rhinitis extend to produce?

A

pharyngotonsilitis

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5
Q

T or F. Infectious rhinitis can lead to secondary bacterial infections?

A

True

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6
Q

What is another name of allergic rhinitis?

A

Hay fever

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7
Q

What are some factors that initiate allergic rhinitis?

A

Hypersensitivity reactions:

- plant pollens, fungi, animal allergens, dust mites

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8
Q

How many of the US population is affected by allergic rhinitis?

A

20%

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9
Q

What is the major pathophysiology behind allergic rhinitis?

A
  • It is an IgE mediate immune response when allergen binds to IgE on mast cells leading to degranulation and release of histamine –> leading to histamine related symptoms
  • has early and late-phase response like asthma (from slides)
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10
Q

What are s/s of allergic rhinitis?

A
  • mucosal edema
  • redness
  • mucus secretion
  • leukocytic infiltration in which esoinophils are prominent
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11
Q

T or F. Allergic rhinitis can be caused by infection?

A

False it is not due to infection but an immune mediated response to an allergen.

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12
Q

Recurrent rhinitis can cause _____ to the walls of the nares.

A
  • focal protrusions of the mucosa such as nasal polyps
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13
Q

What is a nasal polyp made of?

A
  • edematous mucosa harboring hyperplastic or cystic mucous gland infiltrated with neutrophisl, eosinophils, plasma celsl with lymphocytses
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14
Q

Whats the danger with nasal polyps?

A

They can become ulcerated or infectious; obstructs breathing.

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15
Q

What most commonly precedes an acute sinusitis?

A
  • acute or chronic rhinitis
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16
Q

The impairment of draining of sinus by inflammatory edema of the mucosa causes?

A

suppurative exudate, producing empyema of the sinus

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17
Q

Obstruction of outflow in sinusitis can lead to?

A

accumulation of mucous secretions forming mucoceles

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18
Q

A rare complication of sinusitis is that it can cause:

A

Osteomyelitis (bone), cellulitis (skin), meningitis (brain, in immuno-compromised patients)

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19
Q

What are some common inflammatory diseases of the nasopharnyx?

A

common diseases: pharyngitis, tonsillitis
common causes: rhinovirus, echovirus, adenovirus
less common causes: respiratory syncytial viruses and influenza

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20
Q

What are some critical s/s?

A

Redening and edema of mucosa with reactive enlargement nearby tonsils and lymphs nodes

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21
Q

Most common bacterial infection of the nasopharynx is?

A

B-hemolytic streptococci

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22
Q

What is the pseudomembrane?

A

exudative membrane covering the tonsils, looks “white”

-nasopalatine and palatine tonsils are also enlarged and covered with exudate

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23
Q

What are you at risk with the bacterial infection by B-hemolytic streptococci?

A

Risk of rheumatic fever and glomerulonephritis

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24
Q

Explain how rheumatic fever occurs? What organ is in danger?

A

Body makes antibodies against the strep which are “nonspecific.” These antibodies can attack other tissues like the myosin filaments of the heart resulting in cardiac muscle/ valve damage

  • sometimes the kidney gets attacked as well
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25
Q

What are two important characteristics of nasopharyngeal carcinoma?

A
  • close anatomic relationship to lymphoid tissue

- association with EBV infection

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26
Q

What are three important patterns of Nasopharyngeal carcinoma?

A
  • Keratinizing Squamous cell carcinoma (SCC)
  • Non-kertatinizing SCC
  • Undifferentiated/basaloid carcinomas that have an abundant non-neoplastic, lymphocytic infiltrate
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27
Q

What are three risk factors for Nasopharyngeal carcinoma?

A
  • Heredity
  • Age
  • EBV (Ebstein Bar Virus)
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28
Q

A patient with Nasopharyngeal carcinoma would present with what clinical symptoms?

A
  • Nasal obstruction
  • Epistaxis
  • Cervical LN mets (70%)
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29
Q

What is another term for the Larynx? And what are its most common disorders?

A

Voicebox

  • Larygnitis especially in heavy smokers
  • Croup - laryngotracheobronchitis in children
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30
Q

A child comes in with inflammatory narrowing of the airway producing inspiratory stridor. What is the diagnosis?

A

Croup - laryngotracheobronchitis

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31
Q

Laryngitis predisposes people to what?

A

Squamous epithelial metaplasia and sometimes overt carcinoma

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32
Q

What is needed to resolve laryngitis?

A
  • nothing, usually resolves on its own
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33
Q

Reactive nodules or polyps are most found in what two populations?

A
  • heavy smokers

- individual who impose great strain on vocal cords (singer’s nodules –> Pitch perfect haha )

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34
Q

What are the difference between singers’ nodules and polyps?

A
  • Singer’s nodules are bilateral lesions

- Polyps are unilateral

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35
Q

Describe vocal cord nodules and polyps?

A
  • smooth, rounded, sessile or pedunculated excrescences that are a few millimeters in greatest dimension and are located in the true vocal cords
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36
Q

IMPORTANT: What are vocal cord nodules or polyps covered by?

A
  • Covered by squamous epithelium that may become keratotic, hyperplastic, or even slightly dysplastic
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37
Q

What can happen to impinging nodules?

A

ulceration

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38
Q

What are some signs/symptoms of vocal cord nodules or polyps?

A

cause changes in voice and porgressive hoarseness

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39
Q

Do vocal cord polyps or nodules give rise to cancer?

A

Nope.

40
Q

What does dysplastic mean in terms of nodules?

A

Nodules can touch each other and cause ulceration.

41
Q

What are Laryngeal squamous papillomas?

A

Benign neoplasms that are usually located on true vocal cords, form soft rasberry like porliferations rarely more than 1 cm in diameter.

42
Q

What is one of the clinical symptoms of Laryngeal papilloma?

A

Raspy voice

43
Q

What is the process of how we can get hemoptysis with Squamous papilloma?

A

Free edge papilloma –> Ulceration –> Hemoptysis

44
Q

What are the different variations in the number of papillomas in children and adults?

A
  • usually singles in adults and multiple in children
45
Q

What are the two types of virus that cause the squamous papilloma lesions?

A

HPV Type 6 and 11

46
Q

Do squamous papilloma become malignant? Do they recur?

A

NO. and yes, they frequently recur.

47
Q

What population is Squamous cell carcinoma seen in?

A

Chronic male smokers

48
Q

What are contributing factors to getting Squamous Cell Carcinoma?

A

nutritional factors, exposure to asbestos, irradiation, infection with HPV

49
Q

What age group and gender is SCC seen in?

A

men in the 6th decade of life

50
Q

How does SCC manifest?

A

persistent hoarseness, dysphagia, dysphonia

51
Q

Describe the steps of how Acute/chronic otitis media can lead to Paragangliomas?

A

Acute/chronic otitis media –> Ostosclerosis –> polyps –> Labyrinthitis –> Carcinomas –> paragangliomas

52
Q

What population does actue/chronic otitis media occur in usually? Is it usually caused by bacteria or virus .

A
  • infants and children

- Viral typically

53
Q

Describe what type of infection (viral/bacterial) causes the two types of exudate?

A

Serous: viral

- Suppurative: bacterial

54
Q

What are the most common types of bacterial causes of acute/chronic otitis media?

A
  • S. pneumoniae, H. influenzae, M. catarrhalis
55
Q

What can chronic otitis media lead to?

A
  • Cholesteatomas or the formation of stone
56
Q

What are the two devastating pathways that a chronic infection can take?

A
  • Chronic infection –> perforation –> spread into mastoid spaces
  • Chronic infection–> performation –> cranial vault –> temporal cerebritis or abscess
57
Q

What is the main problem that occurs in otosclerosis?

A
  • abnormal bone depsoition in the middle ear about he rim of the oval window into which footplate of the stapes fit
58
Q

What is the pathophysiology of otosclerosis?

A

What is the pathophysiology of otosclerosis? - first there is a fibrous ankylosis of the footplate followed in time by bony overgrowth anchoring into the oval window

59
Q

What ear is usually affected?

A

usually both ears are affected

60
Q

What governs the severity of the situtation?

A

degree of immobilization governs the severity of hearing loss

61
Q

How rapidly does otosclerosis progress?

A

most instances the process is slowly progressive spanning over decades, leading to eventual marked hearing loss

62
Q

What does the brachial cyst arise from?

A

remnants of the 2nd brachial arch

63
Q

What population is branchial cyst most common in?

A

Young adults between ages of 20-40 years

64
Q

What does the content of the cyst look like?

A

It may be clear and water OR mucinous and contain desquamated, granual cellular debris

65
Q

Do the cysts change in size? Are they malignant?

A
  • cysts enlarge slowly

- they are rarely the site of malignant transformation

66
Q

What is the Thyroglossal cyst?

A
  • cysts that are left over when the thyroid migrates from base of tongue into the neck before birth
67
Q

What is the thyroglossal cyst connected to? and where does it lie?

A
  • connected to the back of the tongue by a small tract

- lies in the middle of neck in front of “adam’s apple”

68
Q

What are paraangliomas (carotid body tumor)?

A
  • clusters of neuroendocrine cells associated with sympathetic and parasympathetic systems
69
Q

What is the most common location for paraganglioma?

A
  • It is most often found within the adrenal medulla where they give rise to pheochromocytomas
70
Q

Where do the 70% of extra-adrenal parangangliomas occur?

A

in the head and neck region

71
Q

Define Xerostomia?

A

-decrease in the production of saliva leading to dry mouth

72
Q

What population is the incidence of this the highest?

A

high as 20% in people over 70 YO

73
Q

What are some causes of Xerostomia?

A
  • MAJOR feature of autoimmune disorder SJORGREN SYDNROME (has added symptom of dry eyes)
  • complication of radiation therapy, medications
74
Q

What are some s/s of xersotomia?

A
  • dry mucosa and or atrophy of papillae of tongue with fissuring and ulcerations
75
Q

What are some complications that comes with Xerostomia?

A
  • increased rates of dental caries, candidiasis, difficulty in swallowing and speaking
76
Q

What are Mucoceles and what are the most common cause of them?

A
  • most common lesion of the salivary glands
  • results from either blockage or rupture of salivary gland duct with consequent leakage of saliva into surrounding connective tissue stroma
77
Q

Where are they most often found in the body? What age is most susceptible to them?

A
  • often found on lower lip and result of trauma

- occur at all ages, most common in toddlers, young adults and elderly who are more prone to falling

78
Q

What do mucocele present as clinically?

A
  • fluctuant swellings of lower lip that have a blue trasnlucent hue
  • cytic spaces are filled with mucin and infalmmatory cells and esp macrophages
79
Q

What are Ranula?

A
  • mucoceles that occur in the floor of the mouth
80
Q

How do Ranulas occur?

A

they occur when epithelial-lined cysts that arise when duct of sublingual gland has been damaged

81
Q

What is a plunging ranula?

A
  • description of cyst that has dissected through connective tissue stroma connecting two bellies of mylohydoi muscle
82
Q

What is a sialadentitis and what causes it?

A
  • inflammation of the salivary glands

- induced by trauma, viral/bacterial infection, autoimmune disease

83
Q

What is the most common form of viral sialadentitis?

A
  • Mumps where parotid is specifically is affected
84
Q

What two bacterias are the biggest causes of sialadentitis?

A

S. aureus and streptococcus viridans

85
Q

What is Sialolithiasis?

A

secondary to ductal obstruction produced by stones

86
Q

How does stone formation occur in sialadentisis?

A
  • obstruction by impacted food debris or by edema
87
Q

How common are neoplasms?

A

not very, less than 2% of all tumors

88
Q

T or F? 40% of submandibular, 50% of minor slaivary galnd, 70% to 90% of sublingual tumors are cancerous

A

True

89
Q

What are distinctive s/s of parotid gland tumors?

A

swellings in front of and eblow the ear

90
Q

What are pleomorphic adenoma?

A
  • benign tumors, mixed tumors consisting of both epithelial and messenchymal differnetiation
  • 60% in parotid
91
Q

Does PLAG1 lead to increased cell growht?

A

Yes

92
Q

What is an obvious s/s of pleomorphic adenoma?

A

bulge on the side of the face

93
Q

What is the warthin tumor and what gland does it effect?

A
  • 2nd most common salivary gland neoplasm

- EXCLUSIVELY in the parotid gland

94
Q

What is the risk ratio of someone who smokes vs someone who doesn’t for warthin tumor?

A

8X more likley

95
Q

What is genetically significant of mucoepidermoid carcinoma?

A
  • Balance translocation of chromosome 11 & 19 causes a fusion protein that causes the tumor

Pathology II (10 decks)

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