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S3B1 Pathology > Nasal Cavity & Ear > Flashcards

Nasal Cavity & Ear Flashcards

1
Q

What is the difference between rhinitis & allergic rhinitis?

A

allergic rhinitis will have more eosinophils

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2
Q

What cell is shown in the provided image?

It suggests what type of diagnosis?

A

eosinophil

allergic reaction

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3
Q

What pathology can appear after recurrent attacks of rhinitis?

A

inflammatory polyps

(including “allergic” polyps)

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4
Q

What are nasal polyps?

What types of cells are commonly located within the polyps?

A
  • Focal protrusionso f the respiratory mucosa
    • 3-4 cm
    • edematous stroma
    • mixed inflammatory infiltrate
      • neutrophils, eosinophils, lymphocytes, plasma cells
      • can become fibrotic over time
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5
Q

What secondary problem can be caused by nasal polyps?

A

can provide a barrier that makes it difficult for mucus to drain out of sinuses & nose

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6
Q

What are risk factors in kids for nasal polyps?

A

cystic fibrosis

aspirin sensitivitvity (& asthma)

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7
Q

What pathology is shown in the provided image?

A

nasal polyp

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8
Q

What featurs of the dissected polyp ar important for identification?

A
  • ulcerated & hemorrhagic on the surface
  • shimmery & shiny
    • edema fluid that undermines the mucosa
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9
Q

What pathology is shown in the provided microscopic image?

What features helped you to identify it?

A
  • respiratory-type epithelium
    • ciliated columnar cells
  • inflammatory edematous infiltrate in the stroma
    • edematous b/c looks white
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10
Q

What is the cause of chronic rhinitis?

Risk factors?

A

sequel to repeated attackes of acute rhinitis with superimposed bacterial infection - obstruction providing optimal location for bacterial growth

deviated nasal septum or nasal polyps

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11
Q

What are the two most common causes of sinusitis?

A

preceded by acute or chronit rhinitis

direct extension of dental infection into maxillary sinus

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12
Q

What are the most common causes of chronic sinusitis?

Most common etiology of each?

A
  • repeated acute sinusitis
    • generally accompanied by outflow obstruction by mucosal inflammation
    • oral cavity inhabitants
  • allergic fungal sinusitis
    • Aspergillus
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13
Q

What are the contents of the allergic mucin produced by allergic fungal sinusitis?

A

sloughed epithelial cells

eosinophils

Charcot-Leyden crystals (breakdown products of eosinophils)

perhaps some fungal hyphae (septate that branch at 45 degrees)

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14
Q

What condition predisposes individuals to sinusitis?

Describe this condition.

A

kartageners syndrome (primary ciliary dyskinesia)

autosomal recessive

dynein arm absent/abnormal

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15
Q

What conditions are associatd wtih Kartagener syndrome?

A

sinusitis

bronchietasis

infertility

situs invertis

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16
Q

What complications can result from sinusitis?

A
  • empyema/mucocele
    • abscess with bugs/mucus inside sinuses
  • osteomyelitis
    • when bugs crawl into the bones
  • septic thrombophlebitis or dural venous sinus
    • bugs & inflammation that make a thrombus in dural venous sinus
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17
Q

What pathology is shown in the provided image?

A

frontal sinus mucocele

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18
Q

What are the 3 major necrotizing lesions of the nose & upper airways?

A
  • mucormycosis
  • granulomatosus with polyangitis
  • extranodal Nk/T-cell lymphoma
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19
Q

What patients are particularly susceptible to mucormycosis?

A

Diabetics & immunocompromised

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20
Q

What is granulomatosus with polyangitis?

A

(Wegeners granulomatosis)

T-cell hypersensitivity reaction to inhaled antigens causing nectorizing granulomas in the respiratory tract

vasculitis small & medium vessels

glomerulonephritis

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21
Q

Extranodal NK/T-cell lymphoma is driven by what virus?

Most commonly affected demographic?

A

Epstein Barr Virus driven

Males, 5th-6th decade, asian & latin

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22
Q

What pathology is shown in the provided image?

How can you identify the causitive agent?

How is it treated?

A

Mucormycosis

big, fat hyphae typically aseptate & branch at 90 degrees

Treated surgically b/c fast growth

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23
Q

What pathology is shown in the provided image?

A

Granulomatosis with polyangitis (Wegeners granulomatosis)

necrotizing granulomatous inflammation & vasculitis in small/medium vessels

histiocytes (monocyte) in the microscopic image (multinuceated)

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24
Q

How is granulomatosis with polyangitis (Wegeners granulomatosis) diagnosed?

A

cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) directed agains PR3 or MPO

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25
Q

What are the 3 diseases driven by Epstein Barr Virus?

A
  1. extranodal NK/T-cell lymphoma
  2. Nasopharyngeal carcinoma
  3. Oral Hairy Leukoplakia
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26
Q

What are the most common viral causes of pharyngitis & tonsilitis?

A

Rhino, Echo & Adeno

less common – respiratory syncytial viruses (RSV) & influenza virus

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27
Q

What are the most common bacterial causes of pharyngitis & tonsilitis?

A

B-hemolytic stroptococci (may manifest as late sequelae w/ rheumatic fever & glomerulonephritis)

sometimes– S. aureus

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28
Q

What is a nasopharyngeal angiofibroma?

Most commonly affected demographics?

Treatment?

Complications?

A

Benign tumor found in the posteriolateral roof of nasal cavity - bleed a lot

fair-skinned, red-headed adolescent-youn adults, biological males

Surgical removal (locally aggressive nature)

Can be fatal due to hemorrhage & intracranial extension

29
Q

75% of nasopharyngea angiofibromas have what type of receptors?

A

androgen

30
Q

What features of the provided photo indicate a nasopharyngeal angiofibroma?

A

asymmetry in the R & L maxillary sinus

posterior wall of L sinus is bowed inward by mass extending into nasocavity

31
Q

What pathology is shown in the provided image?

How do you know?

A

nasopharyngeal angiofibroma

respiratory epithelium overlying numeorus blood vessels in a fibrous tissue

vessels are “staghorn” like – (antlers)

32
Q

What is a sinonasal papilloma?

What are the 3 types & which is most dangerous?

Most commonly affected demographic?

A

benign neoplasm of the nasal cavity & paranasal sinuses

papillomatous proliferation of non-keratinizing squamous and/or columnar epithelium on fibrovascular stalk

  1. Endophytic - locally aggressive w/ change malignant transformation
    • grow down into the stroma
  2. Exophytic
  3. Cylindrical

adult males 30 - 60 years

33
Q

Sinonasal Papillomas are related to what virus?

A

HPV

type 6 and 11

34
Q

What pathology is shown in the provided image?

A

Sinonasal papilloma

35
Q

What pathology is shown in the provided image?

How do you know?

A

Papilloma

finger-like proliferation of epithelium on fibrovascular stalk

36
Q

What is a olfactory neuroblastoma?

Most commonly affected demographic?

Symptoms?

Treatment?

A

small round blue cell tumor with neuroendocrine marker

arise from the neuroectodermal olfactory cells in the mucosa

15 & 50 year

Symptoms: nasal obstruction & epistaxis (nose bleed)

Combo surgery, radiation & chemotherapy

37
Q

What is an example of a neuroendocrin marker?

A

chromogranin

38
Q

What pathology is shown in the provided image?

How do you know?

A

Olfactory neuroblastoma

Respiratory epithelium with underlyign infiltrate of small blue cells

39
Q

What 3 characteristics define a nasopharyngeal carcinoma?

Most commonly affected demographics?

Symptoms?

A

Epithelial malignancy arising in nasopharynx positive for Epstein Barr virus

children in africa

adults in southern china

adults & children in US

diets high in nitrosamines (fermented foods & salted fish), smoking & chemical fumes

Symptoms: nasal obstruction, epistaxis & lump in neck (cervical lymph nodes)

40
Q

What type of nasopharyngeal carcinoma has the worst prognosis?

A

keratinizing squamous cell carcinoma

41
Q

What is otits media & what are the most commonly affected demographics?

A

inflammation inner ear

infants & children

diabetic persons

42
Q

Most common etiological causes of otitis media?

A
  • usually viral
  • Bacterial (supperative exudate)
    • acite: Strep. pneumonae, influenzae, Moraxella catarrhalis
    • chronic: Pseudomonas Aeruginosa, S. aureus, Fungus
      • ​ear drum perforation, spread to mastoid process, temporal lob abscess
  • Diabetic person
    • Pseudomonas Aeruginosa
43
Q

What is a cholesteatoma?

It can arise as a complication of what condition?

A

non-neoplastic squamous-lined cyst& filled with amorphous debris/cholesterol

can erode into the ossicles, the labrynth & the adjacent bone

complication of otitis media

44
Q

What is the name for abnormal deposition of bone in the middle ear?

This can lead to what problems?

A

otosclerosis

slowly progressive hearly loss beginng in early decades

45
Q

What pathology is shown in the provided image?

How do you know?

A

Basal cell carcinioma

nodule w/ injected blood vessels on the surface

eroded ulcer

nests of blue cells with peripheral palisating (tumor cells on outside are perpendicular to tumor cells on the inside of the nest)

46
Q

What is the cause of tooth caries?

A

focal demineralization of tooth by acidic metabolites of fermenting surgars from bacteria

47
Q

What is gingivitis?

What is the cause & what can be the result?

A

inflammation of the gums

poor oral hygeine & leads to plaque accumulation

48
Q

What is periodontitis?

A

inflammatory process that affects the supporting structures of the teeth, alveolar bone & cememtum

49
Q

What pathology is shown in the provided image?

A

aphthous ulcer (canker sore)

50
Q

What are aphthous ulcers?

A

single/crops ulceration with a erythematous halo surrounding a yellowish fibropurulent membrane

51
Q

What is shown in the provided image?

A

Irritation (traumatic) fibroma

smoooth pink exophytic nodule on the buccal mucosa

52
Q

What pathology is shown in the provided image?

How do you know?

Most commonly affected demographic?

Complications?

A

Pyogenic granuloma

erythematous, hemorrhagic & extraphytic mass on gingival mucosa

higly vascular proliferation of organizing granulation tissue

most common in children, young adults & pregnant women

can lead to regression or develop into peripheral ossifyign fibroma

53
Q

What pathology is shown in the provided image?

A

Peripheral ossifyign fibroma

54
Q

What pathology is shown in the provided image?

How do you know?

A

Peripheral giant cell granuloma

aggregation of multinucleate, foreign body-like giant cells separated by a fibroangiomatous stroma

55
Q

What pathology is shown in the provided image?

A

Herpes simplex virus infection (type 1 & less commonly type 2)

56
Q

What are the symptoms of Herpes simplex virus infection?

A

can initially present as gingivostomatitis

abrupt onset of vesicles & the ulcers of the oral mucosa

3-4 weeks duration & the dormancy in trigeminal ganglia that results in recurrent stomatitis

57
Q

What pathology is shown in the provided image?

A

gingivostomatitis

58
Q

What type of cell is shown in the provided image?

It is indicative of what pathology?

A

Tzank cell

gigantic epithelial cells with multinucleation

Herpes Smplex virus

59
Q

What pathology is shown in the provided image?

It is most common in what demographics?

A

oral candidiasis pseudo membrane - can be scraped off

(thrush)

immunocompromised, diabetics, steroid inhalers/asthma

60
Q

What pathology is shown by the provided image?

What ar the othe associated symptoms with this illness?

A

Scarlet Fever (Group A Strep)

Raspberry & strawberry tongue (white coating that eventually goes away & leads to hypertrophied taste buds)

Rash that starts at the belt & moves up

61
Q

What pathology is shown in the provided image?

A

Measles

Koplik spots (punctate ulcers on buccal mucosa)

62
Q

What pathology is shown in the provided image?

A

Diptheria

Pseudomembrane that can extend all the way down into the trachea

63
Q

What pathology is shown in the provided image?

A

Lichen Planus (typically cutaneous but can occur in oral mucosa)

hyperkeritosis w/ reticulate (lace-like) patter on buccal mucosa

64
Q

What pathology is shown in the provided image?

A

pemphigus bulgaris

blistering cutaneous disorder that can occur in oral mucosa

Vesicles & bullae prone to rupture

65
Q

What pathology is shown in the provided image?

Most commonly affected demographic?

A

Oral Hairy Leukoplakia

White, confluent pathces of fluffy hyperkerototic thickenings on lateral aspect of tongue

immunocompromised – caused by Epstein Barr Virus

66
Q

How can you differentiate oral hairy leukoplakia from oral candidiasis?

A

the lesions in oral hairy CANNOT be scraped off

the CAN be scraped off with candidiasis

67
Q

What pathology is shown in the provided image?

A

Leukoplakia

25% pre malignant (low-grade squamous dysplasia)

can only be diagnosed after primary causes have been excluded

68
Q

Leukoplakia is associated with what risk factors?

A

smoking, chewing tobacco

69
Q

What pathology is shown in the provided image?

A

Erythroplakia

Red, velvety

risk of malignant gransformation much higher than in leukoplakia (high-grade squamous dysplasia)

S3B1 Pathology (7 decks)

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