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ENT > Pathology > Flashcards

Pathology Flashcards

1
Q

What type of gland forms ear wax?

A

Ceruminous glands

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2
Q

What are the major salivary glands?

A

Parotid glands
Submandibular glands
Sublingual glands

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3
Q

What is otitis media?

A

Inflammation of the middle ear.

Usually due to viral infection.

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4
Q

What is cholesteatoma?

A

An abnormal, non-cancerous skin growth within the middle ear.

May be acquired or congenital.

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5
Q

What should be considered in young patients with bilateral vestibular schwannoma?

A

Neurofibromatosis type 2

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6
Q

What can lead to the development of nasal polyps?

A

Allergy (e.g. aspirin)
Infection
Asthma
Nickel

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7
Q

What should be considered in those with nasal polyps at a young age?

A

Cystic fibrosis

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8
Q

What is Samter’s triad?

A

Bronchial asthma, nasal polyps and aspirin tolerance.

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9
Q

What form of vasculitis is Granulomatosis with Polyangiitis (GPA)?

A

Small vessel

Only affects the respiratory tract and the kidneys.

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10
Q

Which antibodies are seen in GPA?

A

cANCA

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11
Q

Which condition is associated with pANCA antibodies?

A

Microscopic polyangiitis

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12
Q

What are risk factors for nasopharyngeal carcinoma?

A

EBV
Nitrosamines
Occupation
Smoking
Alcohol
HPV

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13
Q

Which cancers are linked to EBV?

A

Burkitt lymphoma
B-cell lymphoma
Hodgkin’s lymphoma

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14
Q

Which forms of HPV cause squamous cell papilloma on the throat?

A

HPV6
HPV11

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15
Q

What are paragangliomas?

A

Tumours arising in clusters around neuroendrocrine cells.

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16
Q

What is the most common cancer of the head and neck?

A

Squamous cell carcinoma

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17
Q

What is sialothiasis?

A

The formation of salivary gland stones.

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18
Q

What is the most common form of salivary gland tumor?

A

Pleomorphic adenoma

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19
Q

What is the purpose of the adenoids?

A

To trap bacteria and viruses on inhalation, presenting them to the immune system.

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20
Q

Why are throat swabs not indicated in tonsillitis?

A

They can often grow bacteria not responsible for the infection.

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21
Q

What should be suspected if sore throat and malaise persist despite antibiotic treatment?

A

Infectious mononucleosis

Order WBC and Paul Bunnell test

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22
Q

How should viral tonsilitis be treated?

A

Mild analgesia - will improve 3-4 days.

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23
Q

How does viral tonsilitis present?

A

Malaise
Fever

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24
Q

How does bacterial tonsilitis present?

A

Systemic upset
Odynophagia
Haliotosis

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25
Q

What symptom of tonsilitis warrants hospital admission?

A

Patient cannot eat/drink.

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26
Q

How does a peritonsillar abscess present?

A

Tonsilitis improved, although now have unilateral pain and odynophagia.

May also have difficulty opening their mouth fully.

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27
Q

How should a peritonsillar abscess be treated?

A

Aspiration
Antibiotics

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28
Q

What can be used to differentiate between bacterial infection and glandular fever?

A

In bacterial infection CRP will be high.

In EBV, CRP is low.

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29
Q

What may occur if amoxicillin given in EBV?

A

Rash

Instead, give penicillin therapy.

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30
Q

What may be the issue in an individual with obligate mouth breathing, a hyponasal voice, and sleep apnoea, alongside acute otitis media?

A

Enlarged adenoids

31
Q

What is OME?

A

Non-acute inflammation of the middle ear, associated with fluid accumulation.

32
Q

Is OME acute or chronic?

A

Tends to be chronic - AOM is acute.

33
Q

Does hearing loss present in OME?

A

Yes, alongside fluid accumulation.

34
Q

Does hearing loss present in AOM?

A

No, there will be fluid accumulation.

35
Q

What are the 2 key environmental risk factors for the development of OME?

A

Older siblings that attend school (increased risk of URTIs)
Smokers in household

36
Q

Is otalgia present in OME?

A

No

37
Q

What does a differentiate between bone conduction and air conduction signify?

A

A conductive hearing loss

38
Q

How is OME treated?

A

Watchful waiting

90% resolve in 3 months, if not better than refer.

39
Q

What are the 3 groupings of hearing loss?

A

Conductive
Sensorineural
Mixed

40
Q

Does otalgia always relate to pain within the ear?

A

No, it may also be referred pain.

41
Q

Why is light reflex displaced upon otoscopy in those with AOM?

A

As tympanic membrane is bulging.

42
Q

Is glue ear infective?

A

Not usually, just the result of eustachian tube dysfunction meaning secretions cannot be cleared.

43
Q

Why should adult OME be investigated?

A

To rule out malignancy as responsible pathogen.

44
Q

What is the most common cause of a perforated ear drum?

A

Acute otitis media

45
Q

What is the most common complication of cholesteatoma/AOM?

A

Spreading infection

46
Q

Which gender is most likely to differ from otosclerosis?

A

Women

It is a form of conductive hearing loss.

47
Q

What occurs in otosclerosis?

A

Fixation of the stapes foot plate to the ovale window.

48
Q

What impact does oestrogen have on the onset of otosclerosis?

A

Increased rate of onset

49
Q

How is otosclerosis?

A

Give patient hearing aids

50
Q

What is the most common form of sensorineural hearing loss?

A

Presbycusis

51
Q

Does bone/air conduction differ in sensorineural hearing loss?

A

No, they both will be reduced.

52
Q

How does noise-induced hearing loss present?

A

Classic dip in hearing at 4kHz

53
Q

In which condition is a Cahart notch seen?

A

Otosclerosis

54
Q

What drugs can cause sensorineural hearing loss?

A

Gentamicin
Cisplatin
Aspirin
NSAIDs (if overdose)

55
Q

What should be investigated in any patient with unilateral hearing loss?

A

Vestibular schwannoma

56
Q

How does vestibular schwannoma often present?

A

Hearing loss
Tinnitus

57
Q

Which scan is indicated in any patient with a unilateral sensorineural hearing loss?

A

MRI scan

58
Q

What does Battle’s sign indicate?

A

Base of skull fracture

Described as bruising of the mastoid.

59
Q

What is vertigo?

A

The sensation of spinning.

60
Q

Which 3 domains must be differentiated between in a patient complaining of dizziness?

A

Cardiac
Neurological
Vestibular

61
Q

Vertigo lasting seconds is likely caused by which condition?

A

BPPV

62
Q

Vertigo lasting hours is likely caused by which condition?

A

Meniere’s disease

63
Q

Vertigo lasting days is likely caused by which condition?

A

Vestibular neuritis

64
Q

How may Meniere’s disease present?

A

Hearing loss
Vertigo (lasting hours)
Tinnitus
Aural pressure

65
Q

What is the diagnostic test for BPPV?

A

Dix-Hallpike maneouvre

66
Q

How is BPPV treated?

A

Epley maneouvre

67
Q

How may vestibular labyrinthitis and vestibular neuritis be differentiated?

A

Hearing loss and tinnitus only seen in vestibular labyrinthitis.

68
Q

Does vestibular schwannoma cause vertigo?

A

Unlikely due to the slow growing nature of the tumor.

Instead will cause a progressive imbalance.

69
Q

Which form of asthma is associated with nasal polyps?

A

Non-allergic form

70
Q

How are nasal polyps treated?

A

Short course of oral steroids, followed by a course of nasal steroids.

71
Q

What should be considered in a child with unilateral nasal discharge?

A

A foreign body

72
Q

How is epiglottitis managed?

A

Intubation

This will secure the airway.

73
Q
A

ENT (6 decks)

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