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Pathophys > Mouth, Throat, Ear, Nose Pathophys > Flashcards

Mouth, Throat, Ear, Nose Pathophys Flashcards

1
Q

Which type of cells line the air tract?

A

Columnar (pseudostratified)

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2
Q

Which type of cells line the food tract?

A

Stratified squamous

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3
Q

What occurs when columnar cells become damaged?

A

Metaplasia- they become squamous

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4
Q

When can you expect deciduous teeth to erupt?

A

6m to 2yrs of age

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5
Q

How many permanent teeth does a human have?

A

32

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6
Q

Which tissue is the most mineralized in the body?

A

Enamel

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7
Q

What is enamel synthesized by?

A

ameloblasts

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8
Q

What does dentin contain?

A

dentinal tubules

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9
Q

What is destroyed by caries?

A

Enamal and Odontoblasts which produce dentin

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10
Q

The pulp is rich in…

A

Nerve bundles, lymphatics, and capillaries

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11
Q

What does the Periodontal ligament do?

A

connects cementum to alveolar bone

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12
Q

What does Periodontal DZ cause?

A

tooth loss

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13
Q

What does S. mutans metabolize?

A

Sucrose to lactic acid

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14
Q

What does Lactobacilli metabolize

A

lactose to lactic acid

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15
Q

What is Bifidobacteria and what can result from it?

A

gram + bacteria used in probiotics. May increase risk for caries.

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16
Q

What does flouride do?

A

incorporates into enamel structure and becomes resistant to degradation by bacterial acids.

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17
Q

what does fluorosis cause?

A

Hypomineralization causing brown pitted enamel and weak(bowed) bones. Occurs with flouide intake >0.05mg/kg/day

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18
Q

What is plaque made from?

A

bacteria, proteins, and desquamated epithelial cells forming a “bacterial bioflim”

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19
Q

What is Calculus?

A

mineralized plaque AKA tartar.

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20
Q

What causes gingivitis?

A

Lack of proper oral hygiene leading to dental plaque and calculus.

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21
Q

Is gingivitis reversible?

A

Yes

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22
Q

What is periodontitis?

A

Inflammation of supporting structures (periodontal lig., alveolar bone, and cementum)

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23
Q

Is periodontitis only caused from gingivitis?

A

No, it can also be an independent DZ or present with other systemic DZs

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24
Q

Which bacteria cause periodontitis?

A

Actinobacillus, Porphyromanas, Prevotella

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25
Q

What are the manifestations of Periodontitis?

A

loosening or loss of teeth

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26
Q

What criteria are used for periodontitis diagnosis?

A

Main=attachment loss,
2nd= Probing depth,
3rd= Radiographic alveolar bone loss

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27
Q

Periodontitis Tx?

A

Includes debridement, scaling and root planing of subgingival biofilm and calculus by a periodontist, general dentist or dental hygienist. Topical or systemic antibiotics can be used in adjunct.

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28
Q

What are Fibrous proliferative lesions of the oral cavity

A

Fibroma (61%), peripheral ossifying fibroma(22%), Pyogenic granuloma (12%), peripheral giant cell granuloma (5%)

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29
Q

Where do most oral fibromas occur?

A

Buccal mucosa along bite line

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30
Q

oral fibroma Tx?

A

surgical excision if bothersome. Cannot aspirate bc it is fibrolytic with few inflammation cells.

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31
Q

How do you recognize a pyogenic granuloma?

A

They occur in gingiva and are red to purple due to it being highly vascularized

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32
Q

Pyogenic granuloma Tx?

A

regress spontaneously or surgical excision

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33
Q

Which type of lesion can occur in the oral cavity with pregnancy?

A

Pyogenic granuloma- no need for treatment

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34
Q

peripheral ossifying fibroma Tx?

A

surgical excision down to periosteum

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35
Q

What are peripheral giant cell granulomas made from?

A

Made of aggregation of multinucleate foreign body like giant cells separated by fibroangiomatous stroma

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36
Q

Peripheral giant cell granuloma Tx?

A

refer to ENT or Oral Surgery

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37
Q

What 2 diseases can Aphthous ulcers be associated with?

A

Celiac, IBD

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38
Q

What is Plummer-Vinson or Paterson-Kelly syndrome?

A

Combination of iron deficiency anemia, glossitis and esophageal dysphagia

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39
Q

What is glossitis associated with?

A 
Vitamin B12 deficiency
Deficiency of:  riboflavin, niacin, or pyridoxine
Sprue and iron deficiency anemia
Bact or viral infection
Irritants= tobacco, ETOH, spices
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40
Q

Which type of Herpes is most common for oral infections?

A

HSV type1

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41
Q

What is herpetic gingivostomatitis?

A

abrupt onset of vesicle and ulcerations in oral cavity

42
Q

Oral HSV Tx?

A

Symptomatic Tx-acyclovir (within 72 to 96hrs)

43
Q

Which form of oral candidiasis is Thrush?

A

Pseudo membranous form. It can be scrapped off

44
Q

Which form of oral candidiasis cannot be scrapped off?

A

Hyperplasitic

45
Q

What is important to remember with oral disorders?

A

Many occur from systemic Dzs. Its important to look at the big picture.

46
Q

What are premalignant lesions of the oral cavity?

A

Leukoplakias, erythroplakia, oral lichen planus

47
Q

What are malignant lesions of the oral cavity?

A

squamous cell carcinoma(HPV is a major cause)

48
Q

What causes oral lichen planus?

A

chronic inflammatory autoimmune disorder with many phenotypes

49
Q

What does hypermethylation of the p16 gene cause?

A

Inactivation of p16( a inhibitor of cyclin-dependent kinase) = hyperplasia

50
Q

What does a mutation of p53 cause

A

dysplasia (size, shape, organization)

51
Q

95% of cancers of the head and neck are SCC. What are the remaining?

A

adenocacinomas (salivary gland in origin)

52
Q

What size would indicate Head and neck squamous cell carcinomas(HNSCC) having a low chance of metastasis?

A

less than 4mm in depth

53
Q

how are HNSCC lesions less than 2cm in diameter treated?

A

often cured by local resection

54
Q

What are the pathogenesis of HNSCC

A 
Often multifactoral from...
Smoking
Alcohol
Actinic radiation(sunlight)
HPV
55
Q

Where does HNSCC often metastasize to?

A

submandibular, superficial and deep cervial lymph nodes. A majority of those who die from HNSCC have a distant site.

56
Q

What is a dentigerous cyst

A

Cyst around crown of unerupted tooth. Often associated with impacted third molar.

57
Q

What can incomplete excision of a dentigerous cyst cause?

A 
Recurrence,
Neoplastic transformation (ameloblastoma)
58
Q

What viruses often cause infectious rhinitis?

A

adenovirus, echoviruses, rhinoviruses

59
Q

What are signs of infectious rhinitis

A

nasal mucosa thickened, edematous and red, nasal cavities narrowed, turbinates enlarged

60
Q

What are nasal polyps often related to ?

A

Allergies- contains inflammatory cells

61
Q

What is recurrent acute rhinosinusitis?

A

4 or more episodes of ARS per year with interim symptom resolution. Usually results from drainage problem in sinuses.

62
Q

What can impaired sinusitis drainage with a suppurative exudate lead to?

A

Empyema (collection of pus)

63
Q

What is “saddle nose” associated with?

A

wegener granulomatosis

64
Q

Nasopharyngeal Angiofibroma Tx?

A

May respond to estrogen therapy

65
Q

What is sinonasal (Schneiderian) papilloma associated with?

A

HPV types 6 and 11

66
Q

what are the 3 types of Sinonasal papilloma?

A

1) Everted- origin on nasal septum
2) Inverted- origin on lateral nasal or sinus wall
3) cylindrical or oncocytic

67
Q

Where do olfactory neuroblastomas arise from?

A

olfacoty mucosa (neuroendocranial cells) covering superior third of nasal septum

68
Q

What is the geographical distribution of nasopharyngeal carcinoma?

A

African children, Chinese adults w/ HLA-A2

69
Q

What the factors contribute to development of nasopharyngeal carcinoma?

A

Heredity, age, and EBV

70
Q

What therapy is nasopharyngeal carcinoma most sensitive to?

A

Radiation

71
Q

Where does nasopharyngeal carcinoma commonly metastasize to?

A

Cervical lymph nodes

72
Q

What causes laryngoepiglottitis?

A

respiratory syncytial virus, H. flu or beta hemolytic strep

73
Q

What is laryngotracheobronchitis?

A

Croup- narrowing produces inspiratory stridor

74
Q

Of singers nodules and polyps, which are unilateral and which are bilateral?

A

singer nodules are usually bilateral, polyps are unilateral

75
Q

Are singers nodules or polyps malignant?

A

They rarely transform to malignancy

76
Q

What are squamous papilloma?

A

benign neoplasms on true vocal cords.

77
Q

What can cause multiple recurring papilloma of the vocal cords?

A

HPV 6 and 11

78
Q

What is the difference between intrinsic and extrinsic laryngeal carcinoma?

A

Intrinsic is confined within larynx. Extrinsic arises or extends outside larynx.

79
Q

What is the most common manifestation of laryngeal carcinoma?

A

Hoarseness

80
Q

What type of cells compose the the outer surface of the TM?

A

squamous epithelium

81
Q

What type of cells compose the inner surface of the TM?

A

cuboidal epithelium

82
Q

What type of cells compose the middle layer of the TM?

A

dense fibrous epithelium

83
Q

What causes relapsing polychondritis?

A

Antibodies to type 2 collegen and chrondroitin sulfate

84
Q

relapsing polychondritis Tx?

A

steroids

85
Q

What causes malignant OE?

A

pseudomonas aeruginosa

86
Q

What can occur with chronic serous OM

A

goblet cell metaplasia

87
Q

Can otosclerosis be genetic?

A

Yes, autosomial dominant

88
Q

Where are branchial cleft cysts located?

A

lateral part of the neck

89
Q

What causes branchial cysts?

A

failure of obliteration of the second branchial cleft in embryonic development causing excess fluid buildup

90
Q

What causes thyroglossal duct cyst?

A

Same etiology as branchial cleft cyst. Remnants of thyroid follicles in cyst.

91
Q

What are the locations of thyroglossal duct cysts?

A

Intralingual-2%
suprahyoid-24%
thyrohyoid-61%
suprasternal-13%

92
Q

Are thyroglossal duct cysts malignant?

A

Potentially, thyroid cancer present in 1-2% of cysts

93
Q

Thyroglossal duct cyst Tx?

A

Sistrunk operation- excision of cyst as well as the tract which passes through the central portion of the hyoid bone to the base of the tongue.

94
Q

What is a paraganglioma?

A

Carotid body tumor- develops within the adventitia of the medial aspect of the carotid bifurcation.

95
Q

What are the different types of carotid body tumors?

A

Familial, Sporadic, Hyperplastic

96
Q

What is characteristic about the rate of growth in paragangliomas?

A

slow-growing tumor- 7 yr doubling time

97
Q

Paraganglioma presentation?

A

Typically asymptomatic palpable neck mass in the anterior triangle of the neck. 10% involve cranial nerve palsy.

98
Q

What is Xerostomia?

A

“dry mouth” due to a decrease in production of saliva. Associated with Sjogren syndrome.

99
Q

What is Sjogren Syndrome?

A

autoimmune against salivary and lacrimal glands. Decreases tear and saliva production.

100
Q

What can be caused by blockage or rupture of salivary gland ducts?

A

Mucoceles

101
Q

What are benign tumors of the facial lymphatics?

A

pleomorphic adenoma, warthin tumor(papillary cystadenoma lymphomatosum)

102
Q

What are malignant tumors of facial lymphatics?

A

mucoepidermoid carcinoma, adenoid cystic carcinoma

Pathophys (15 decks)

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