Head & Neck Flashcards
1
Q
Choanal atresia
A
- Septum b/w nose and pharynx
- Newborns turn cyanotic when breast-feeding, pink again after crying
- Associated with other congenital anomalies
2
Q
Nasal polyps
A
- Nonneoplastic, result of chronic inflammation
- Allergic polyps with h/o IgE allergies
- Can be cystic fibrosis-associated
3
Q
Obstructive sleep apnea
A
- Obesity MCC; also tonsillar hypertrophy, septal deviation, hypothyroidism, acromegaly
- Decreased PaO2 and O2 sat; respiratory acidosis during apneic episodes
- Can cause pulmonary HTN followed by RVH, as well as secondary polycythemia as EPO tries to compensate for hypoxemia
4
Q
Sinusitis most common organisms
A
Strep pneumoniae, H. influenzae, Moraxella catarrhalis
5
Q
Nasopharyngeal carcinoma
A
- Male-dominant, inc. in Chinese and African pops
- EBV association
- Neurologic Sx, hearing disturbance, CN involvement
- Metastasizes early to cervical lymph nodes
- SCC, nonkeratinizing squamous carcinoma, or undifferentiated
6
Q
Laryngeal carcinoma
A
- Risk factors: smoking, alcohol, squamous papillomas, papillomatosis (HPV 6 and 11)
- Mostly located on true vocal cords
- Mostly keratinizing SCCs
- Hoarseness with cervical lymphadenopathy
7
Q
Oral manifestations of HIV
A
Candidiasis, aphthous ulcers (painful ulcers covered by shaggy gray membrane), hairy leukoplakia, Kaposi sarcoma in hard palate
8
Q
Dental caries organisms
A
Strep viridans or mutans
9
Q
Behçet syndrome
A
- Turkey and Mediterranean
- Immune complex small vessel vasculitis
- Recurrent aphthous ulcers and genital ulcerations, uveitis, erythema nodosum
10
Q
Leukoplakia and erythroleukoplakia
A
- Squamous hyperplasia of epidermis
- High rate of progression to cancer
- Oral hairy leukoplakia: shaggy parakeratosis
11
Q
Squamous papilloma
A
- Ages 20-40
- Benign, exophytic tumor with fibrovascular core
- Associated w/ HPV 6, 11
- In larynx, may obstruct airway
- Rarely, progresses to SCC
12
Q
Ameloblastoma
A
- Locally invasive but non-metastasizing
- Arises from enamel organ epithelium or dentigerous cyst
- “Soap bubble” appearance in bone
- May have APC gene mutation
13
Q
Sjögren syndrome
A
- Autoimmune destruction of salivary and lacrimal glands (dry eyes)
- Associated with RA
- Glands replaced by immune cells + germinal centers
14
Q
Pleomorphic adenoma
A
- Often middle-aged women
- Usually on parotid gland
- Painless, movable mass at angle of jaw
- Epithelial cells w/ myxomatous and cartilaginous stroma
- May become malignant (sign: facial nerve involvement)
- PLAG1 gene activated in 8q12 translocation
15
Q
Warthin tumor
A
- Most common in men 50+
- Benign parotid gland tumor
- Risk from smoking
- Heterotopic salivary gland tissue trapped in benign lymphoid tissue of node
16
Q
Mucoepidermoid carcinoma
A
- Most common malignant salivary gland tumor, usu. located in parotid gland
- Mixture of neoplastic squamous and mucous-secreting cells
- MECT1-MAML2 gene fusion
17
Q
Vincent angina
A
- Necrotizing ulcerative gingivitis with necrotic pseudomembrane
- Fusospirochetal infection of Borrelia vincentii
18
Q
Noma (cancrum oris)
A
- Rapidly spreading gangrene of oral and facial tissues, exposing bone
- Fusospirochetal infection in malnourished/debilitated pts
19
Q
Ludwig angina
A
- Cellulitis that spreads from submaxillary or sublingual space
- Related to dental extraction or floor of mouth trauma
- May cause mycotic ICA aneurysm
- May dissect into pleural space, pericardium
20
Q
Actinomycosis
A
- Chronic granulomatous inflammation, abscesses that drain by fistula formation
- Suppurative infection with yellow “sulfur granules”
21
Q
Dentigerous cyst
A
Fluid b/w crown of impacted/unerupted tooth (usu. 3rd molar) and enamel epithelium
22
Q
Mucocutaneous leishmaniasis
A
- Central & South America
- Skin sores followed by lesions of nose or upper lip
- Tuberculoid granulomatous response
23
Q
Wegener granulomatosis
A
- Vasculitis, ischemic necrosis, chronic inflammation, giant cells, microabscesses
- No actual granulomas
- Septal perforation, mucosal ulceration, progressive destruction of nose and paranasal sinuses
- “Saddle nose” deformity
- Elevated ANCAs and PR3
24
Q
Schneiderian papilloma
A
- Benign neoplasm of sinonasal mucosa
* Squamous or columnar epithelial proliferation
25
Q
Inverted papilloma
A
- Benign neoplasm in lateral nasal wall, may spread to sinuses
- Epithelium inverts into underlying stroma
- HPV 6 and 11
- Increased SCC risk
26
Q
Olfactory neuroblastoma
A
- Ages 10-19 or 50-59
- Superior inner nose
- Neural crest origin (express NSE)
- May display rosettes
- Lymphatic spread
27
Q
Nasal-type angiocentric NK/T-cell lymphoma
A
- EBV association
- Tumor cells surround and infiltrate blood vessels, causing local ischemia/necrosis
- Ulcers covered by black crust; midface skin involvement
28
Q
Complications of peritonsillar abscess
A
- Obstruct or rupture into airway
- Weaken carotid artery wall
- Penetrate into mediastinum or base of skull
29
Q
Nasopharyngeal angiofibroma
A
- Boys 10-19
- Benign but locally invasive highly vascular pharyngeal neoplasm
- Posterolateral nasal wall w/ local mass effect
- May regress spontaneously
- Association with familial adenomatous polyposis (FAP) syndrome
30
Q
Chordoma
A
- Age 40+
- Originate from clivus, may reach nasopharynx
- Large vacuolated cells w/ abundant ICM
31
Q
Chondrosarcoma
A
- Men 70+
- Nonepithelial
- Exophytic, polyploid mass in pharynx
32
Q
Oncocytoma (oxyphil adenoma)
A
- Benign epithelial cells swollen w/ mitochondria
* May proliferate in parotid glands of elderly
33
Q
Adenoid cystic carcinoma
A
- 40-60 y/o
- Slow-growing tumor of minor salivary gland (usually), often painful
- “Cylindromatous” appearance on histology
- t(6;9) translocation
34
Q
Acinic cell adenocarcinoma
A
- Men 20-30 y/o
- Small round masses in parotid gland
- Uniform cells w/ abundant basophilic cytoplasm
