pathology Flashcards
what are the auditory meatus and external canal lined with?
epidermis (stratified squamous)
what lines the middle ear?
columnar lined mucosa
what does the middle ear contain
ossicles, opening of eustachian tube and mastoid cavity
what does the inner ear contain?
-cochlea and vestibular apparatus
what are the three parts of the cochlea?
- scala vistibuli
- cochlear duct
- scala tympani
what detects linear movements?
utricle
saccule
what is nasal vestibule made up of?
squamous epithelium
what are the major/minor salivary glands?
major glands (paired):
- parotid
- submandibular
- sublingual
minor:
-salivary glands
what components are slivary glands made up of?
acinar component and ductular component
what cells are found in salivary glands>
- serous cells
- mucinous component
- ducts
- myoepithelial cells
what is otitis media?
URTI involving middle ear by extension of infection of eustachian tube
what is a cholesteatoma?
an abnormal collection of skin cells deep inside your ear due to abnormal keratin production usually from chronic otitis media and perforated tympanic membrane
who is otitis media more common in?
children
how do you get otitis media?
usually viral
Ocasionally bacterial:
- strep, pneumonia
- H.influenze
- moraxella
- strep.pyogenes
who do cholesteatoma usually affect?
- common
- any age
- more commonly male
pathogenesis of aquired cholesteatoma?
chronic otitis media and perforated tympanic membrane
pathogenesis of congenital cholesteatoma?
proliferation of embryonic rest
what are majority of ear tumours?
SCC
pathogenesis of ear tumours?
related to chronic inflammation or radiation
most common tumour of temporal bone?
vestibular schwannoma
are vestibular schwannoma usually bilateral?
no- unilateral and sporadic (95%)
what would you consider if you found bilateral vestibular schwannoma in young patient?
consider neurofibromatosis (NF) type 2
what is rhinitis?
infectious rhinitis= common cold (viral)
allergic rhinitis= hay fever (IgE mediated type 1 hypersensitivty reaction)
what causes sinusitis?
- can be due to dental problem
- usually following rhinitis
who are nasal polyps found in?
common (not children)
equal sex distrubution
associated with cystic fibrosis
what is ganulomatosis with polyangitis?
- small vessel vasculitis wiht necrosis
- rare
- more common in men
- ENT problems
- renal disease
what antibodies are associated with GPA?
cANCA
what are most common benign nasal lesions?
squamous cell papillomas
what are most common malignant nasal lesions?
SSC
what are the 3 types of sinonasal papilloma?
inverted, exophytic and oncocytic
who are sinonasal papillomas usually seen in?
> 50s
males
HPV
what are symptoms of sinonasal papillomas ?
blocked nose
sinonasal papillomas malingant or benign?
benign- dont often undergo malignant change
who are nasopharyngeal carcinomas usually seen in?
males Epstein virus FH smoking alcohol HPV working with wood, dust
what are the types of nasopharyngeal carcinomas
keratinising SCC (more aggresive locally but less likely to metastasize)
non keratinising SCC
baseloid SCC
what are laryngeal polyps?
- reactive chnage in laryngeal mucosa secondary to vocal abuse, infection and smoking
- asociated with hypothyroidism
what are contact ulcers?
benign response to injury found posterior vocal cord
what is the most common benign disease of the larynx?
squamous cell papilloma/papillomatosis
what are squamous cell papilloma/papillomatosis associated with?
HPV exposure
when do squamous cell papillomas/papillomatosis usually occur?
<5 years
between 20-40
are squamous cell papillomas agressive?
in children yes
in adults they are often solitary
what are paragangliomas?
tumours arising from neuroendocrine cells dispersed throughout the body
what is a paraganglioma in adrenal glands called?
pheochromocytoma
what are the most common tumours in the head and neck?
SCC
what are risk factors for SCC?
smoking, alcohol, HPV
how does SCC develop?
- hyperplasia
- dysplasia
- malignancy
what type of HPV are most cases of HPV associated with?
HPV type 16
pathophysiology of HPV?
produces proteins E6 and E7 which disrupts p53 and RB pathways respectively, leading to cellular immortality
what are sialolithiasis?
stones within salivary glands
what salivary gland most commonly has tumours?
parotid
in what salivary glands are tumours more often malignant?
smaller glands
how can you tell if salivary gland is probably malignant?
-if young and the mass is painful
what are the most common salivary tumour?
pleomorphic adenoma
where are pleomorphic adenoma usually found?
parotid but can be found any salivary gland
are pleomorphic adenoma malignant?
can be benign or malignant
who does pleomorphic adenoma commonly occur in?
- females
- 30 to 60
what are the second most common benign tumour in salivary gland?
warthins tumour
who are warthins tumour more common in?
- men
- smokers
is mucoepidermoid carcinoma benign or malingnant?
malignant
where are mucoepidermoid carcinoma typically found?
parotid but can occur in any salivary gland
what are mucoepidermoid carcinoma associated with?
MECT1-MAML2 fusion
are adenoid cystic carcinomas benign or malignant?
malignant (most common of palate)
how does otitis media present?
- ear ache
- discharge
- hearing loss
- lethargy
- fever
- red swollen ear drum on inspection
what investigations are done for otitis media?
if ear drum perforates swab and test
most common bacteria:
- Strep pnemoniae
- H. influenza
- Moraxella
- Strep pyogenes
treatment for otitis media?
80% resolve in 4 days without antibiotics
1st line= amoxicillin
2nd line= erythromycin
how does cholesteatoma present?
- 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
what is the investigations done for cholesteatoma?
diffusion weight MRI
what is the management for cholesteoma?
surgery
