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ENT > Pathology > Flashcards

Pathology Flashcards

1
Q

What glands does the ear contain?

A

sebaceous and ceruminous

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2
Q

What type of mucosa is found in the middle ear?

A

columnar lined mucosa

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3
Q

What type of epithelium is found in the nasal vestibule?

A

squamous

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4
Q

What type of epithelium is found in the nose, sinus etc?

A

schneiderian epithelium

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5
Q

What is Scneiderian epithelium?

A

identical to respiratory epithelium

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6
Q

What is respiratory epithelium

A

pseudostratified ciliated columnar. Sero-mucinous glands

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7
Q

What covers the true vocal cords?

A

squamous epithelium

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8
Q

What are the 2 components of salivary glands?

A

acinar component and ductular

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9
Q

What do the serous cells contain?

A

digestive enzymes including amylase

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10
Q

What is the purpose of the peripheral myoepithelial cells?

A

contractile properties

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11
Q

What usually causes otitis media?

A

viruses

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12
Q

What bacteria can cause otitis media?

A

strep. pneumoniae; H.influenzae; moxarella

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13
Q

What organism should be suspected in chronic otitis media?

A

psuedomonas

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14
Q

What is cholesteatoma?

A

abnormally situated squamous epithelium with high cell turnover and abundant keratin which stimulates inflam

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15
Q

Where are cholesteatomas found?

A

superior posterior middle ear and/or petrous apex

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16
Q

What are the causes of cholesteatoma?

A

chronic otitis media and perforated tympanic membrane

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17
Q

What age group gets cholesteatoma?

A

any age group

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18
Q

What is a vestibular Schwannoma?

A

benign tumour of Schwann cells of the vestibular portion of CNVIII

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19
Q

What is the function of Schwann cells?

A

produce myelin for nerve cells

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20
Q

Where are vestibular Schwannomas typically found?

A

in the temporal bone at the cerebellopontine angle- make up 80-90% of tumours found here.

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21
Q

What should be considered if a patient has bilteral vestibular schwannomas and are young?

A

neurofibromatosis type 2

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22
Q

What is the genetic inheritance for NF1?

A

autosomal dominant

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23
Q

What is seen with NF1?

A

widespread neurofibromas; bony defects; cafe-au-lait spots; axillary freckling; lisch nodules; learning disabilities; short stature

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24
Q

What is seen on pathology of vestibular Schwannoma?

A

elongated cells with nuclear palisading- nuclei line up together (Verocay bodies)

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25
Q

What is seen with NF2?

A

cafe-au-lait spots (less than type 2); bilateral vestibular schwannoma; cataracts; optic glioma; meningioma

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26
Q

What are the aetiologies of nasal polyps?

A

allergy; infection; asthma; aspirin sensitivity; nickel exposure

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27
Q

What should be considered in the young with nasal polyps?

A

CF

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28
Q

What is Samters triad?

A

asthma; aspirin sensitivity and nasal polyps

29
Q

What is seen on pathology of nasal polyps?

A

filled with fluid- only respirayory epithelium left- everything else has been puoshed away by the fluid

30
Q

What are the features of upper airway disease in GPA?

A

nasal obstruction; ulcers; epistaxis; destruction of the nasal septum; sinusitis

31
Q

What are the antibodies found in GPA?

A

cANCA directed against PR3

32
Q

Who gets GPA?

A

usually white and >40years

33
Q

What is nasopharyngeal carcinoma associated with?

A

EBV; volatile nitrosamines in food

34
Q

Who gets nasophayrngeal carcinoma?

A

very high incidence in far east; males

35
Q

What cells does EBV infect?

A

epithelial cells of oropharynx and B cell

36
Q

How is EBV involved in carcinogenesis?

A

EBV hi-jacks and mimicks helper T cell responses leading to proliferation and survival of B cells- increased risk of lymphoma

37
Q

what causes of laryngeal polyps?

A

reactive change in laryngeal mucosa secondary to vocal abuse; infection and smoking, occ. in hypothyroidism

38
Q

Where do laryngeal polyps tend to occur?

A

posterior aspect of cords

39
Q

What should be suspected in anterior polyps?

A

more likely to be malignant

40
Q

What is the difference between nodules and polyps?

A

nodules are bilateral and seen in young women; polyps are unilateral and pedunculated

41
Q

What can cause contact ulcers?

A

chronic throat infection; voice abuse; GORD

42
Q

What is seen on pathology of contact ulcers?

A

similar to nodules and polyps but with the addition of ulceration and granulation tissues- new blood vessels and fibrous tissue

43
Q

What are the 2 peaks of incidence with papillomatosis?

A

<5 years and between 20-40

44
Q

What is papillomatosis realted to?

A

HPV exposure- 6&11

45
Q

Who gets papillomatosis worse?

A

in children it is a more aggressive disease whereas in adults they tend to be solitary

46
Q

What is the name for a squamous epithelial cell that has undergone nuermous changes due to infection by HPV?

A

koilocytosis

47
Q

Waht is a paraganglioma?

A

a tmour arising from neuroendocrine cells

48
Q

What are chromaffin +ve paraganglioma?

A

seen typically below the diaphragm and affect the sympathetic nervous system- secrete catecholamines eg phaeochromocytoma

49
Q

What do chromaffin -ve paragangliomas affect?

A

carotid and aortic bodies’ clusters around oral cavity, nose, nasopharynx, larynx and orbit

50
Q

What is seen in MEN1?

A

parathyroid adenoma
pancreas endocrine tumours
pituitary prolactinoma

51
Q

What is seen in MEN 2?

A

medullary thyroid carcinoma; phaeochromocytoma; parathyroid hyperplasia

52
Q

What can paragangliomas arise as a part of?

A

MEN2

53
Q

What are the risk factors for developing SCC?

A

alcohol; smoking; HPV

54
Q

How is HPV involved in carcinogenesis?

A

produces proteins E6 and E7 which disrupt p53 and RB pathways leading to cellular immortality

55
Q

What type of HPV is associated with SCCs?

A

16

56
Q

What is the most common site for salivary gland tumours?

A

parotid

57
Q

What are tumours in smaller glands more likely ot be?

A

malignant

58
Q

What is sialolithiasis?

A

stones in salivary glands

59
Q

What is the most common tumour of the salivary glands?

A

pleomorphic adenoma

60
Q

Who gets pleomorphic adenomas?

A

females over 60

61
Q

Why are pleomorphic adenomas difficult to excise?

A

recurrence

62
Q

What is the risk is pleomorphic adenomas are left?

A

malignant transformation

63
Q

What is Warthin’s tumour?

A

second most common benign tumour of salivary glands

64
Q

Who gets Warthin’s tumour?

A

males over 50

65
Q

hwat is Warthin’s associated with?

A

smoking

66
Q

What is the most common carcinoma of the salivary glands worldwide?

A

mucoepidermoid carcinoma

67
Q

What is the most common carcinoma of the salivary glands in the UK?

A

adenoid cystic carcinoma

68
Q

Why do patients get pain early on with adenoid cystic carcinomas?

A

frequent perineural invasion

69
Q

Who gets adneoid cystic carcinomas?

A

over 40s; affects parotid most commonly

ENT (13 decks)

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