Head and Neck Flashcards

1
Q

What is herpetic stomatitis commonly known as, and what virus is it caused by?

A
  • cold sore

- HSV1

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2
Q

Where does HSV1 survive in dormant state?

A

In the nerves ganglion corresponding to site of infection (on face usually trigeminal ganglia)

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3
Q

What is Moniliasis?

A

Another name for Candidiasis or “thrush”

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4
Q

Is candidiasis easily scraped off?

A

yes

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5
Q

What type of conditions predispose someone to candidiasis?

A

diabetes

immunocompromised (e.g. HIV)

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6
Q

What is a mucocele?

A

Obstruction of oral mucosa mucous gland resulting in a cystic dilation of duct filled with mucin. Due to trauma or inflammation. Not neoplastic.

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7
Q

T/F- Leukoplakia and erythroplasia are potentially premalignant lesions?

A

True

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8
Q

Can leukoplakia be removed by simple scraping of the lesion?

A

no

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9
Q

What causes leukoplakia?

A

irritation and inflammation

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10
Q

T/F- leukoplakia is usually malignant?

A

False, only 1-15% are pre-cancerous

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11
Q

Looking at leukoplakia under a microscope, what two characteristics will you see?

A
  1. kyperkeratosis

2. mucosal epithelial hyperplasia

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12
Q

Is erythroplasia more or less likely to progress into cancer than leukoplakia?

A

erythroplasia (50%)

leukoplakia (1-15%)

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13
Q

T/F- in general prognosis worsens corresponding to the further back in the mouth/phayrnx the lesion is?

A

true

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14
Q

What is the most common malignant tumor of the oral region?

A

squamous cell carcinoma

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15
Q

What virus is often responsible for causing rhinitis?

A

adenovirus

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16
Q

Repeated episodes of allergic rhinitis can lead to what condition of the nose?

A

thick mucosa and nasal polyps

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17
Q

Name 2 causes of necrotizing granulomatous sinusitis

A
  1. wegeners granulomatosis

2. Mucor (zygomycetes) fungal infection

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18
Q

T/F- we would expect to see fibrinoid necrosis of vessels in wegeners granulomatosis

A

true

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19
Q

T/F- mucor (zygomycetes infection is rarely fatal

A

False, fatal infections often occur due to extension of fungal elements into the brain. This is a medical emergency.

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20
Q

What is an angiofibroma?

A

Rare, benign neoplastic lesion consisting of blood vessels and fibrous tissue often found in or on the nose of young males (10-20 yrs)

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21
Q

What is a potential complication of an angiofibroma?

A

Fatal blood loss

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22
Q

A plasmacytoma is made of of what type of cells?

A

plasma cells

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23
Q

An esthesioneuroblastoma comes from what cells?

A

olfactory nerve

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24
Q

Nasopharyngeal carcinoma (NPC) comes from what type of tissue?

A

squamous epithelium

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25
Q

Name two types of sqaumous carcinomas

A
  1. keratinizing

2. non-keratinizing with lymphoid infiltration (lymphoepithelioma)

26
Q

What virus has been known to be associated with all types of nasopharyngeal carcinomas?

A

Epstein Barr virus (EBV)

27
Q

Is laryngitis caused by viral, bacterial, or either type of infection?

A

either one can cause it

28
Q

Benign, non-neoplastic polyps filled with mixed tissue in the submucosa of the larynx are seen in what 3 types of patients? How would you treat?

A
  • singers
  • smokers
  • patients with GI reflux
  • Treat with medical or surgical therapy
29
Q

Benign, NEOPLASTIC, squmous cell papillomas of the larynx are treated with surgical therapy. What virus can cause multiple recurrences of this, particularly in juveniles?

A

HPV

30
Q

> 2 weeks of hoarseness is concerning for what?

A

malignant tumor of the larynx

31
Q

What type of carcinoma accounts for 90% of all malignancies of larynx?

A

sqaumous cell

32
Q

Name 2 common causes of squamous carcinoma? Survival depends on what?

A
  • ETOH, smoking

- stage of cancer

33
Q

A congenital branchial cleft cyst is residual trapped epithelium from the embryonic branchial cleft closure. Does it appear medial or lateral and what is the corrective therapy?

A
  • LATERAL (BELOW EAR)

- surgical therapy

34
Q

A congenital thyroglossal duct cyst is trapped thyroid epithelium and often involves the hyoid. Does it appear medial or lateral?

A

Midline (form tongue to thyroid)

correct with surgery

35
Q

What is the only benign tumor of the external ear briefly mentioned in class?

A

epidermal inclusion cysts

36
Q

T/F- chronic otitis media is most often due to dysfunciton of the eustachian tube but can also result from a tympanic membrane perforation that failed to heal after trauma or infection.

A

true, most often non-suppurative or serous

37
Q

What is a cholesteatoma?

A
  • Post-inflammatory, non-neoplastic epidermal cyst of the middle ear
  • can be congenital
38
Q

What is the epithelial proliferation of a cholesteatoma derived form and what is a negative outcome of this condition?

A
  • epithelium proliferation of the middle ear that can be derived from tympanic membrane after inflammation / rupture
  • damaged surrounding structures by expansion
39
Q

An acoustic neuroma/schwannoma is derived from what cells? What is a possible negative outcome?

A
  • Schwann cells of the vestibular nerve

- unilateral deafness

40
Q

T/F- otosclerosis is a common cause of hearing loss in young adults

A

true

41
Q

Which salivary gland accounts for 85% of salivary gland tumors?

A

parotid

42
Q

T/F- most parotid tumors are malignant

A

False, 65-80% are benign

43
Q

T/F- the smaller the gland, the more likely it is to be malignant

A

true

44
Q

Are salivary gland tumors fast or slow growing?

A

slow

45
Q

T/F- pleomorphic adenomas are benign and the most common tumor of salivary glands, and most often occur in the parotid

A

true

46
Q

What cells will you see histologically in a pleomorphic adenoma?

A

“mixed tumor”

  • epithelial cells (ducts, acini)
  • mesenchymal cells (myoepithelial cells, chondroid, mixed areas)
47
Q

What is a problem with surgical removal of pleomorphic adenomas of the parotid gland?

A

Total excision of parotid gland tumors is hampered by the facial nerve running through the gland (separating the superficial and deep lobes). The majority of pleomorphic adenomas occur in the superficial lobe.

48
Q

Do pleomorphic adenomas recur if not completely excised?

A

Recurrence 5-50% if not completely removed. Rarely, the epithelial or both epithelial and mesenchymal elements become malignant.

49
Q

What is carcinoma ex pleomorphic adenoma?

A

epithelial elements of pleomorphic adenoma become malignant

50
Q

What is craniosarcoma?

A

mesenchymal elements of pleomorphic adenoma become malignant

51
Q

What is the 2nd most common salivary gland tumor? What demographic is most at risk?

A
  • Warthin’s Tumor (Papillary cystadenoma lymphomatosum)

- older men

52
Q

What is the source of cells for Warthins tumor? Is this tumor benign or malignant?

A
  • epithelial cells trapped in parotid lymph nodes

- benign

53
Q

What would you see on histology of a worthins tumor?

A

-epithelial cells trapped in parotid lymph nodes

54
Q

What is the most common malignancy of the salivary glands?

A

mucoepidermoid carcinoma

55
Q

Is prognosis good or bad for a mucoepidermoid carcinoma?

A
  • depends on degree of differentiation
  • low grade: >90% survival at 5 years
  • high grade: 20-40% survival at 5 years
56
Q

What is an adenoid cystic carcinoma?

A
  • myoepithelial cell tumor of the major and minor salivary glands
  • cribiform “swiss cheese” pattern
57
Q

What type of invasion will you see with an adenoid cystic carcinoma?

A

PERINEURAL INVASION

58
Q

What’s the behavior of an adenoid cystic carcinoma?

A

indolent course marked by frequent recurrence

59
Q

What gland is most often affected by acinic cell carcinoma? Is the prognosis good or bad?

A
  • parotid gland

- slow growing, 5 yr survival is 90%

60
Q

What will you see under microscope in an acinic cell carcinoma?

A

-acinar cells with large zymogen granules