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ENT > granulomatous disease of thee nose > Flashcards

granulomatous disease of thee nose Flashcards

1
Q

what is a granuloma ?

A

chronic inflammation
microscopically a bunch of epitheliod cells in the centre surrounded by lymphocytes
epitheliod cells may eventually fuse and form giant cells

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2
Q

what are the causes of granulomatous diseases of the nose ?

A

neoplastic
infectious
immunological
idiopathic
fungal

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3
Q

what are the immunological causes of granulomatous diseases of the nose ?

A

Lupus
Behcet disease

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4
Q

what are the idiopathic causes of granulomatous diseases of thee nose ?

A

sarcoidosis

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5
Q

what is the causative organism of rhinoscleroma ?

A

klebeseilla rhinoscleromatis

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6
Q

what are the stages of rhinoscleroma ?

A

catarrhal stage
granulomatous stage
cicatricial stage

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7
Q

what are thee featurees of thee catarrhal stage of rhinoscleroma ?

A

purulent rhinorrhea
nasal honeycombed crusting

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8
Q

what are the features of the granulomatous stage of rhinoscleroma ?

A

granulomatous nodules usually appear at the mucocutaneous junction
subdermal infiltration of lower part external nose and upper lip

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9
Q

what are the features of the cicatricial stage ?

A

dense fibrotic reactions that may eventually stenose the nose and the larynx along with the tracheobronchial tree

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10
Q

what are the investigations for cases of rhinoscleroma ?

A

biopsy

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11
Q

what are the pathogonomic findings in a biopsy taken from a rhinoscleroma patient ?

A

mikulicz cells and Russell bodies
infiltration of lymphocytes, plasma cells and lymphocytes

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12
Q

what do mikulicz cells look like under the microscope ?

A

large nucleated foam cells with a vacuolated cytoplasm that contain the causative bacilli

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13
Q

what are Russel bodies ?

A

homogenous eosinophilic inclusion bodies that reside inside plasma cells as a consequence of plasma cell over stimulation

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14
Q

what is the treatment for Rhinoscleroma ?

A

long term therapy with either streptomycin or tetracyclin
surgical:
dilatation may be needed for stenosis formed in cicatricial stages

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15
Q

what iis the causative organism in leprosy ?

A

mycobacteerium leprae

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16
Q

what is the presentatioin of leprosy ?

A

hypopigmentetd macules, tuberculoid skin
mucosal nodules in the mouth and the nose that subsequently ulcerate
lymphadenopathy
nasal septal perforation
fish mouth deformity
loss of eyebrows

17
Q

what is the treatment for leprosy ?

A

dapsone

18
Q

what is the causative organism in tuberculosis ?

A

mycobacteriium tubrculosis

19
Q

what is th presentation of tuberculosis ?

A

secondary to lung tuberculosis
first nodular infiltration of anterior septum
ulceration and perforation

20
Q

what is the treatment for tuberculosis ?

A

anti TB drugs
Rifampicin
isoniazid
pyrazidine
ethambutol

21
Q

what is thee causative organism in syphillus ?

A

treeponaeum pallidum

22
Q

what is the clinical presentation of primary syphillus ?

A

chancre in oral mucosa

23
Q

what is thee preesentation of secondary syphillus ?

A

rhinitis with crusting and fissuring in nasal vestibule

24
Q

what is thee presentation of tertiary syphillus ?

A

granulomatous involvement of the oral and nasal mucosa, bony nasal septum perforation
neurosyphillus

25
Q

what is the investigation for cases of syphillus ?

A

FTA-ABS

26
Q

what is the treatment for syphillus ?

A

penicillin

27
Q

which of the iinfectious causes of granulomatous diseases of the nose cause septal perforation ?

A

syphillus
TB
Leprosy

28
Q

what is thee other name for leprosy ?

A

hansen’s disease

29
Q

which of the infectious causes of granulomatous diseases of the nose cause septal perforation ?

A

syphillus
TB
Leprosy

30
Q

what type of nasal septal perforation is sen in tertiary syphillus ?

A

bony septal perforation
( posterior perforation )

ENT (30 decks)

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