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ENT > pathology > Flashcards

pathology Flashcards

1
Q

what are the auditory meatus and external canal lined with?

A

epidermis (stratified squamous)

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2
Q

what lines the middle ear?

A

columnar lined mucosa

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3
Q

what does the middle ear contain

A

ossicles, opening of eustachian tube and mastoid cavity

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4
Q

what does the inner ear contain?

A

-cochlea and vestibular apparatus

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5
Q

what are the three parts of the cochlea?

A
  • scala vistibuli
  • cochlear duct
  • scala tympani
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6
Q

what detects linear movements?

A

utricle

saccule

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7
Q

what is nasal vestibule made up of?

A

squamous epithelium

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8
Q

what are the major/minor salivary glands?

A

major glands (paired):

  • parotid
  • submandibular
  • sublingual

minor:
-salivary glands

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9
Q

what components are slivary glands made up of?

A

acinar component and ductular component

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10
Q

what cells are found in salivary glands>

A
  • serous cells
  • mucinous component
  • ducts
  • myoepithelial cells
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11
Q

what is otitis media?

A

URTI involving middle ear by extension of infection of eustachian tube

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12
Q

what is a cholesteatoma?

A

an abnormal collection of skin cells deep inside your ear due to abnormal keratin production usually from chronic otitis media and perforated tympanic membrane

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13
Q

who is otitis media more common in?

A

children

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14
Q

how do you get otitis media?

A

usually viral

Ocasionally bacterial:

  • strep, pneumonia
  • H.influenze
  • moraxella
  • strep.pyogenes
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15
Q

who do cholesteatoma usually affect?

A
  • common
  • any age
  • more commonly male
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16
Q

pathogenesis of aquired cholesteatoma?

A

chronic otitis media and perforated tympanic membrane

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17
Q

pathogenesis of congenital cholesteatoma?

A

proliferation of embryonic rest

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18
Q

what are majority of ear tumours?

A

SCC

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19
Q

pathogenesis of ear tumours?

A

related to chronic inflammation or radiation

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20
Q

most common tumour of temporal bone?

A

vestibular schwannoma

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21
Q

are vestibular schwannoma usually bilateral?

A

no- unilateral and sporadic (95%)

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22
Q

what would you consider if you found bilateral vestibular schwannoma in young patient?

A

consider neurofibromatosis (NF) type 2

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23
Q

what is rhinitis?

A

infectious rhinitis= common cold (viral)

allergic rhinitis= hay fever (IgE mediated type 1 hypersensitivty reaction)

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24
Q

what causes sinusitis?

A
  • can be due to dental problem

- usually following rhinitis

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25
Q

who are nasal polyps found in?

A

common (not children)
equal sex distrubution
associated with cystic fibrosis

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26
Q

what is ganulomatosis with polyangitis?

A
  • small vessel vasculitis wiht necrosis
  • rare
  • more common in men
  • ENT problems
  • renal disease
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27
Q

what antibodies are associated with GPA?

A

cANCA

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28
Q

what are most common benign nasal lesions?

A

squamous cell papillomas

29
Q

what are most common malignant nasal lesions?

A

SSC

30
Q

what are the 3 types of sinonasal papilloma?

A

inverted, exophytic and oncocytic

31
Q

who are sinonasal papillomas usually seen in?

A

> 50s
males
HPV

32
Q

what are symptoms of sinonasal papillomas ?

A

blocked nose

33
Q

sinonasal papillomas malingant or benign?

A

benign- dont often undergo malignant change

34
Q

who are nasopharyngeal carcinomas usually seen in?

A 
males
Epstein virus
FH
smoking
alcohol
HPV
working with wood, dust
35
Q

what are the types of nasopharyngeal carcinomas

A

keratinising SCC (more aggresive locally but less likely to metastasize)
non keratinising SCC
baseloid SCC

36
Q

what are laryngeal polyps?

A
  • reactive chnage in laryngeal mucosa secondary to vocal abuse, infection and smoking
  • asociated with hypothyroidism
37
Q

what are contact ulcers?

A

benign response to injury found posterior vocal cord

38
Q

what is the most common benign disease of the larynx?

A

squamous cell papilloma/papillomatosis

39
Q

what are squamous cell papilloma/papillomatosis associated with?

A

HPV exposure

40
Q

when do squamous cell papillomas/papillomatosis usually occur?

A

<5 years

between 20-40

41
Q

are squamous cell papillomas agressive?

A

in children yes

in adults they are often solitary

42
Q

what are paragangliomas?

A

tumours arising from neuroendocrine cells dispersed throughout the body

43
Q

what is a paraganglioma in adrenal glands called?

A

pheochromocytoma

44
Q

what are the most common tumours in the head and neck?

A

SCC

45
Q

what are risk factors for SCC?

A

smoking, alcohol, HPV

46
Q

how does SCC develop?

A
  • hyperplasia
  • dysplasia
  • malignancy
47
Q

what type of HPV are most cases of HPV associated with?

A

HPV type 16

48
Q

pathophysiology of HPV?

A

produces proteins E6 and E7 which disrupts p53 and RB pathways respectively, leading to cellular immortality

49
Q

what are sialolithiasis?

A

stones within salivary glands

50
Q

what salivary gland most commonly has tumours?

A

parotid

51
Q

in what salivary glands are tumours more often malignant?

A

smaller glands

52
Q

how can you tell if salivary gland is probably malignant?

A

-if young and the mass is painful

53
Q

what are the most common salivary tumour?

A

pleomorphic adenoma

54
Q

where are pleomorphic adenoma usually found?

A

parotid but can be found any salivary gland

55
Q

are pleomorphic adenoma malignant?

A

can be benign or malignant

56
Q

who does pleomorphic adenoma commonly occur in?

A
  • females

- 30 to 60

57
Q

what are the second most common benign tumour in salivary gland?

A

warthins tumour

58
Q

who are warthins tumour more common in?

A
  • men

- smokers

59
Q

is mucoepidermoid carcinoma benign or malingnant?

A

malignant

60
Q

where are mucoepidermoid carcinoma typically found?

A

parotid but can occur in any salivary gland

61
Q

what are mucoepidermoid carcinoma associated with?

A

MECT1-MAML2 fusion

62
Q

are adenoid cystic carcinomas benign or malignant?

A

malignant (most common of palate)

63
Q

how does otitis media present?

A
  • ear ache
  • discharge
  • hearing loss
  • lethargy
  • fever
  • red swollen ear drum on inspection
64
Q

what investigations are done for otitis media?

A

if ear drum perforates swab and test

most common bacteria:

  • Strep pnemoniae
  • H. influenza
  • Moraxella
  • Strep pyogenes
65
Q

treatment for otitis media?

A

80% resolve in 4 days without antibiotics

1st line= amoxicillin
2nd line= erythromycin

66
Q

how does cholesteatoma present?

A
  • usually only one ear affected
  • persistent or recurring watery, often smelly, discharge from the ear which can come and go or be continuous
  • a gradual hearing loss
67
Q

what is the investigations done for cholesteatoma?

A

diffusion weight MRI

68
Q

what is the management for cholesteoma?

A

surgery

ENT (33 decks)

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