Nose, throat and tonsil pathology Flashcards
What should you not use to diagnosis rhino or sinusitis?
XR
What two broad categories of rhino/sinusitis are there?
Infective
Non-infective
What can cause infective rhino/sinusitis?
Common cold mainly
What are some symptoms of infective rhino/sinusitis?
Facial pain
Discharge
Nasal blockage
How do you treat infective rhino/sinusitis?
Decongestants
Analgesics
Antibiotics- if chronic
What two categories of non-infective rhino/sinusitis are there?
Allergic
Non-allergic
What can cause non-allergic rhino/sinusitis?
Polyps
Vasomotor rhinitis
What kind of reaction is allergic rhino/sinusitis?
IgE mediated Type 1 HS
How do you treat allergic rhino/sinusitis?
Avoidance
Antihistamines
Topical steroids
Combination
What are nasal polyps?
Swellings of the nasal mucosa
What can cause nasal polyps?
Infection Allergic Asthma Aspirin Nickel exposure CF
How do you treat nasal polyps?
oral steroids
topical steroids
Surgery
What is Granulomatosis with polyangiitis commonly called and where does it affect?
Wenger’s
Nose
What is Granulomatosis with polyangiitis?
Inflammation of the blood vessels in the nose
What can cause Granulomatosis with polyangiitis?
Autoimmune
What are some symptoms of Granulomatosis with polyangiitis?
Necrosis Small vessel vasculitis Pulmonary and renal disease Septal perforation ANCA +ive
What benign tumours can affect the nose?
Squamous papilloma
Angiofibromas
Schneiderian papillomas
What causes Schneiderian papillomas?
HPV Smoking Solvent abuse welding >50yo
What is a symptom of Schneiderian papillomas?
Nasal blockage
What malignant tumour can affect the nose?
SCC
What 4 ‘unique’ cancers can affect the nose?
Lymphoma
Nasopharyngeal carcinoma
Primary adenocarcinoma
Neuroblastoma
What can cause nasopharyngeal carcinoma?
EBV
Where are laryngeal polyps/nodules found?
Throat
Differentiate a laryngeal polyp from a nodule
Polyp- unilateral
Nodule- bilateral
What can cause laryngeal polyps/nodules?
Vocal abuse
Infection
Smoking
Hypothyroidism
What is an ulcer in the throat?
Benign response to injury
Where are throat ulcers usually found?
Posterior vocal cord
What can cause throat ulcers?
Chronic throat clearing
Voice abuse
GORD
Intubation
What can cause papillomas in the throat?
HPV 6 and 11
What cancer is common in the throat?
SCC
What can cause SCC in the throat?
HPV
Smoking
Alcohol
What two forms of paraganglioma are there?
Chormaffin positive
Non-Chromaffin
What are some causes of airway obstruction?
Inflammation- Allergic and infective Foreign bodies Compression Trauma Neurological neoplastic Burn
What makes children susceptible to choking?
Big heads Small nostrils Obligate nasal breathers Large tongues Small soft larynx Weak neck muscles Narrow subglottis
What things can affect the tonsils?
Tonsillitis (acute and chronic) Obstructive hyperplasia Malignancy Tonsil crypt debris / tonsiliths Otitis media with effusion Glandular fever/infectious mononucleosis
What can cause acute tonsillitis?
Viral (major)
Bacterial
What viruses cause acute tonsillitis?
EBV
Rhinovirus
Influenza
Give some differentials for acute tonsillitis?
URTI Infectious mononucleosis Peritonsular abscess Candida infection malignancy Diptheria Scarlet fever
What are some symptoms of viral acute tonsillitis?
Malaise Fever Sore throat Lymphadenopathy Lasts 3-4 days
What are some symptoms of bacterial acute tonsillitis?
Systemic upset Fever Odynophagia Halitosis Lymphadenopathy Lasts longer than a week
How do you treat acute tonsillitis?
Support
AB- penicillin or clarithromycin
Surgery
What is a complication of acute tonsillitis?
Peritonsillar abscess
What are some symptoms of a peritonsillar abscess?
Unilateral throat pain
3-7 days after tonsilitis
Medial displacement of uvula
Concavity of palate
What is the major cause of chronic tonsillitis?
Bacteria
What bacteria can cause chronic tonsillitis?
Strep pyogenes
S. Aureus
H. Influenza
Strep pneumonia
What are some symptoms of chronic tonsillitis?
Chronic sore throat Bad breath Tonsilloliths Peritonsillar erythema Lymphadenopathy
What two areas can cause obstructive hyperplasia?
Adenoids
Tonsilis
Give some symptoms of adenoid obstructive hyperplasia?
Obligate mouth breathing
Hyponasal voice
Snoring
AOM/OME
Give some symptoms of tonsil obstructive hyperplasia?
Snoring
Muffled voice
Dysphagia
What is the common name for infectious mononucleosis
Glandular fever
What is glandular fever?
Infectious mononucleosis
What causes Infectious mononucleosis?
EBV
What are some symptoms of Infectious mononucleosis?
Gross tonsillar enlargement with exudate
Lymphadenopathy
Hepatosplenomegaly
Low CRP
how do you treat Infectious mononucleosis?
Symptomatic treatment
Antibiotics
Steroids
No ampicillin!!!
What must you not use in Infectious mononucleosis?
AMPICILLIN!!!
What pathology can you get in the salivary glands?
Sialolithiasis
What is Sialolithiasis?
Stones in salivary glands
What virus can infect the salivary glands?
Paramyxovirus- causes mumps
What benign tumours can affect the salivary glands?
Pleomorphic adenomas
Warthins
Oncocytoma
Monomorphic
What malignant tumours can affect the salivary glands?
Mucoepidermoid
Adenoid cyst
Acinci cell carcinoma
SSC
