Pathology Flashcards
What is otitis media?
Inflammation of the middle ear that occurs mostly in children
What are some bacterial causes of otitis media?
Strep. pneumoniae
H. influenzae
What are the main causative organisms of chronic otitis media?
Pseudomonas aeruginosa
Staph aureus
What is cholesteatoma?
Growth consisting of keratinizing squamous epithelium in the middle ear +/- mastoid process
What causes acquired cholesteatoma?
Chronic otitis media
Perforated tympanic membrane
What causes congenital cholesteatoma?
Proliferation of embryonic rest
How does a macro cholesteatoma present in the ear?
A pearly white mass in the middle ear
How does a micro cholesteatoma present in the ear?
Squamous epithelium with abundant keratin production, associated with inflammation
What diagnosis makes up the majority of ear tumours?
Squamous cell carcinoma
What nerve is associated with a vestibular schwannoma?
Vestibular portion of the vestibulocochlear nerve (VIII)
Where do vestibular scwhannomas occur?
Within the temporal bone
What should be considered in a young patient with bilateral vestibular scwannomas?
Neurofibromatosis T2
What are the main aetiologies for nasal polyps?
Allergy, infection, asthma, aspirin sensitivity and nickel exposure
What are micro nasal polyps associated with?
Allergic aetiologies associated with eosinophils
What is granulomatosis with polyangiitis characterised by?
Small vessel vasculitis and necrosis typically limited to the respiratory tract and kidneys
How does GPA present?
Respiratory symptoms
Renal disease
Nasal symptoms of congestion
What is the most common benign tumours of the nose?
Squamous cell papillomas
What is the most common malignant nose tumour?
Squamous cell carcinoma
What are the three types of sinonasal papilloma?
Inverted
Exophytic
Oncocytic
What is the main aetiology of sinonasal papilloma?
Low risk HPV
Where are nasopharyngeal carcinomas more likely to occur?
Far east and parts of Africa
What is nasopharyngeal carcinoma associated with?
EBV
Volatile nitrosamines in food
What causes laryngeal polyps?
A reactive change in laryngeal mucosa secondary to vocal abuse, infection and smoking
What causes contact ulcers?
A benign response to injury - chronic throat clearing, voice abuse, GORD, intubation etc.
What does EBV virus do?
EBV genes ‘hi-jack’ normal signalling pathways
How does macro squamous cell papilloma of the throat present?
An exophytic, sessile or pedunculated mass
How does micro squamous cell papilloma of the throat present?
Finger-like projection
A fibrovascular core covered by stratified squamous epithelium
What is the most common tumour seen in the head and neck?
Squamous cell carcinoma
Where is the most common site of squamous cell carcinoma in the head and neck?
Oropharynx
What are the main risk factors for squamous cell carcinoma in the head and neck?
Smoking and alcohol
How does HPV lead to tumour development?
Increased expression of proteins E6 and E7 which disrupt p53 and RB pathways respectively
This leads to cellular immortality - preventing apoptosis
What are sialolithiasis?
Stones in the salivary glands
What is a common viral infection of the salivary glands?
Mumps - paramyxoma virus
What is the most common site in salivary glands for tumours to occur?
Parotid gland
Which salivary gland tumours are most likely to be malignant?
Tumours of smaller salivary glands (submandibular / sublingual)
What is the most common benign tumour of the salivary glands?
Pleomorphic adenoma
What are the common symptoms of sialolithiasis?
Blocking and pain of salivary glands
What is the second most common benign tumour of the salivary glands?
Warthin’s tumour
What are Warthin’s tumours strongly associated with?
Smoking
What is the most common malignant tumour of the salivary glands worldwide?
Mucoepidermoid carcinoma
What is the most common malignant tumour of the salivary glands in the UK?
Adenoid cystic carcinoma
