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ENT > Pathology > Flashcards

Pathology Flashcards

1
Q

What is the external acoustic canal lined with and contain?

A

epidermis (skin) and contain sebaceous and ceruminous glands

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2
Q

What does this mean?

A

any dermatology condition can affect the outer ear

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3
Q

What is the middle ear lined with and contain?

A

columnar lined mucosa and contains ossicles (malleus, incus and stapes)

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4
Q

What is in the inner ear?

A

the cochlea and vestibular apparatus

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5
Q

What is the mucous like in the nose?

A

Squamous at tip, majority is respiratory (schneiderian) epithelium and olfactory mucosa at superoposterior aspect of nose.

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6
Q

What glands are in the nose?

A

Seromucinous glands

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7
Q

When does squamous epithelium become respiratory epithelium in the throat?

A

At the level of the true chords.

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8
Q

What are the salivary glands?

A

Exocrine glands with acinar and ductular components.

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9
Q

What are the 3 components of salivary glands?

A 
serous cells (contain digestive enzymes)
mucinous component (clear/grey staining)
peripheral myoepithelial cells (squeeze everything along)
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10
Q

Identify these components

A

pale = mucinous component
light purple = serous cells
dark purple = peripheral myoepithelial cells

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11
Q

What is otitis media?

A

Inflammation of the middle ear

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12
Q

What usually causes otitis media?

A

Viral infection (sometime bacteria from strep pneumoniae, haemophilus influenzae)

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13
Q

What is the cause if it is chronic otitis media?

A

Pseudomonas aeruginosa

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14
Q

What agents can be used against psuedomonas?

A

Cephalosporins (ceftazidime)

Quinolone (ciprofloxacin) or penicillins

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15
Q

What is a cholesteatoma?

A

NOT a tumour or to do with cholesterol

Is when keratinising epithelium is found in the middle ear

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16
Q

How will a cholesteatoma present?

A

With discharge if perforated the tympanic membrane or a white surface seen on membrane.

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17
Q

Why is there a high keratin production in cholesteatoma?

A

Because squamous epithelium has a high cell turnover and abundant keratin production.

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18
Q

What is a vestibular schwannoma?

A

Benign tumour of the schwann cells on the vestibular portion of the vestibulocochlear nerve.

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19
Q

Are schwannomas only found in ENT region?

A

No as schwann cells are found all over the body

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20
Q

Where do most vestibular schwannomas occur?

A

80-90% occur at the cerebropontine angle (connection between the cerebellum and pons)

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21
Q

If someone presents with a bilateral schwannoma and is young what do you suspect?

A

Neurofibromatosis type 2

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22
Q

What is also associated with NF-2?

A

NF1
multiple meninhiomas
gliomas
cafe au lait macules

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23
Q

Are nasal polyps common in children?

A

no - if see this then suspect cystic fibrosis (should have other symptoms too)

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24
Q

What are causes of nasal polyps?

A

allergy, infection, asthma, aspirin sensitivity

25
Q

What is the presentation of a nasal polyp?

A

Vascular dilation and oedema (results in large swelling) but not clinically painful.

26
Q

What is rhinitis?

A

Inflammation of the mucous membrane of the nose

27
Q

What is sinusitis?

A

Inflammation of the sinsuses

28
Q

What are the causes of rhinitis and sinusitis?

A

Infection, allergic (IgE mediated)

29
Q

What is granulomatosis with polyangitis?

A

autoimmune disease characterised by small vessel inflammation in the respiratory tract and kidneys

30
Q

What will GPA present with?

A

pulmonary problems, renal disease, congestion, septal perforation

31
Q

How would you diagnose GPA?

A

cANCA antibody, biopsy

32
Q

What is the most common malignant tumour of the nose?

A

SCC

33
Q

What is the nasopharyngeal carcinoma associated with?

A

Epstein-barr virus (causes glandular fever)

34
Q

What is nasopharygeal carcinoma caused by epstein-barr virus ass with?

A

lymphomas

35
Q

What causes laryngeal polyps?

A

Reactive change in mucosa secondary to vocal chord abus e.g. constant rubbing together of chrods, reflux of stomach acid, infection and smoking

36
Q

What is a contact ulcer and what causes it?

A

benign response to injury and chronic throat and voice abuse

37
Q

What causes a squamous papilloma and who is most affected?

A

HPV 6 and 11

<5 years and 20-40 years

38
Q

What can be done to reduce the risk of a squamous papilloma?

A

HPV vaccine

39
Q

What is histologically diagnostic of a papilloma?

A

A warty appearance with finger-like projections

40
Q

What is a paraganglioma?

A

Tumours that arise in clusters of neuroendocrine cells dispersed through the body.

41
Q

Where are paragangliomas common?

A

In the head and neck

42
Q

What condition are paragangliomas associated with?

A

MEN 2 but can also be something more sinister so always refer.

43
Q

Can HPC cause a SCC?

A

yes

44
Q

What else can cause SCC in the head and neck?

A

smoking and alcohol

45
Q

How does HPV cause cancers?

A

by releasing 2 toxins - E6 and E7 which attack p53 and RB (tumour suppressor proteins) and thus results in cell immortality.

46
Q

Where will the primary SCC normally present?

A

base of the tongue

47
Q

Where will the SCC spread to?

A

the lymphatics

48
Q

Is SCC responsive to chemo and radiotherapy?

A

YES - very

49
Q

Which salivary gland is most commonly affected by tumours?

A

Parotid

50
Q

if there is a tumour in a smaller gland is it more likely to be malignant r benign?

A

Malignant

51
Q

What does painful mass in the parotid gland usually indicate?

A

Indicates that the tumour has invaded the facial nerve (which passes through the parotid)

52
Q

What is the most common tumour of the salivary gland?

A

pleomorphic adenoma

53
Q

Pleomorphic adenomas has a high rate of recurrence - why?

A

They are difficult to excise

54
Q

Can pleomorphic adenomas become malignant?

A

Yes they have the risk of malignant transformation but only if had for 20-30 years.

55
Q

What is a Warthin’s tumour?

A

Second most common benign tumour within the parotid gland with a strong association with smoking

56
Q

What is the common presentation of a warthin’s tumour?

A

Bilateral and multicentric

57
Q

What is the most common malignant tumour in the world?

A

mucoepidermoid carcinoma

58
Q

What is the most common malignant tumour in the UK?

A

adenoid cystic carcinoma

59
Q

What is characteristic of an adenoid cystic tumour?

A

Nasty tumour that invades nerves early so can creep up to the brain. They are also often difficult to excise so recur often - ‘slow growing and sinster’

ENT (11 decks)

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