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ENT > Pathology > Flashcards

Pathology Flashcards

1
Q

The auditory meatus and external canal are lined by what?

A

Epidermis (skin)

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2
Q

What glands are found along the auditory meatus and external canal?

A

Sebaceous and ceruminous glands

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3
Q

What type of mucosa lines the middle ear?

A

Columnar mucosa (glandular)

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4
Q

What is the nasal vestibule lined by?

A

Keratinised stratified squamous epithelium

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5
Q

What are the majority of the nose and the sinuses lined by?

A

Respiratory epithelium- pseudo stratified ciliated columnar which is mucus secreting

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6
Q

What two types of epithelium can be found in the throat?

A

Respiratory or squamous, depending on the site

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7
Q

What type of glands are salivary glands? What two components do they have?

A

Exocrine glands with acinar and ductular components.

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8
Q

What is otitis media?

A

Inflammation of the middle ear

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9
Q

Is otitis media more likely to be bacterial or viral?

A

Viral

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10
Q

If otitis media is bacterial, what are some organisms which can cause it?

A

Strep Pneumoniae, H. Influenzae, Moraxella Catarrhalis

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11
Q

What organism is most likely to be the cause of chronic otitis media?

A

Pseudomonas Aeruginosa

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12
Q

Where can cholesteatoma occur?

A

Superior posterior middle ear and/or petrous apex

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13
Q

Give two causes of cholesteatoma?

A

Chronic otitis media or perforated tympanic membrane

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14
Q

What is the abnormality which occurs in cholesteatoma?

A

There is abnormally situated squamous epithelium in the middle ear with high cell turnover and abundant keratin

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15
Q

Vestibular Schwannoma is associated with what nerve?

A

The vestibular nerve (part of CNVIII)

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16
Q

Within which bone does vestibular schwannoma occur?

A

Temporal

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17
Q

95% of cases of vestibular schwannoma are?

A

Sporadic and unilateral

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18
Q

What should be considered in a patient with bilateral vestibular schwannoma who is young?

A

Neurofibromatosis Type 2

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19
Q

How is type 2 neurofibromatosis inherited?

A

Autosomal dominant (but usually sporadic)

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20
Q

Which is more common, NF1 or NF2?

A

NF1

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21
Q

What gene is affected in NF2?

A

NF2 gene which encodes the merlin protein (tumour suppressor)

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22
Q

Give 4 features of NF2?

A

Bilateral vestibular schwannoma, multiple meningiomas, gliomas and cafe au lait macules

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23
Q

Who are unlikely to get nasal polyps?

A

Children

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24
Q

What should be considered in a young patient with nasal polyps?

A

CF

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25
Q

Give some examples of causes of nasal polyps?

A

Allergy, infection, asthma, aspirin sensitivity

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26
Q

What is allergic rhinitis/sinusitis mediated by?

A

IgE

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27
Q

Who does GPA tend to affect?

A

White patients > 40

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28
Q

Patients with GPA will be positive for what?

A

cANCA

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29
Q

Give two examples of benign tumours of the nose?

A

Squamous papillomas, angiofibromas

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30
Q

What is the most common malignant lesion in the nose?

A

Squamous cell carcinoma

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31
Q

Where has a high incidence of nasopharyngeal carcinoma? Which sex is this most common in?

A

Far East- more common in males

32
Q

Nasopharyngeal carcinoma has a very strong association with what?

A

Epstein-Barr virus

33
Q

Where does Epstein-Barr virus affect?

A

Epithelial cells of the oropharynx and B cells

34
Q

The Epstein-Barr virus encodes EBNA-2, activating ? to promote transition from ?

A

Cyclin D, G0-G1

35
Q

What happens in a laryngeal polyp?

A

There is a reactive change in laryngeal mucosa secondary to vocal abuse, infection or smoking

36
Q

What endocrine condition can laryngeal polyps occur in?

A

Hypothyroidism

37
Q

Who are laryngeal nodules usually seen in and where?

A

Younger women, usually bilateral on the middle-posterior 1/3rds of the vocal cords

38
Q

Are laryngeal polyps usually unilateral or bilateral?

A

Unilateral

39
Q

What is a benign response to injury which can occur in the throat?

A

Contact ulcer

40
Q

Give 3 causes of a contact ulcer?

A

Chronic throat, GORD, vocal abuse

41
Q

When are the two peak incidences of squamous papilloma in the throat?

A

< 5 years, and 20-40 years

42
Q

Squamous papilloma in the throat is related to what?

A

HPV types 6 and 11

43
Q

In which group of people is squamous papilloma a more aggressive disease?

A

Children

44
Q

What are paraganglioma?

A

Clusters of neuroendocrine cells dispersed through the body

45
Q

What two types of paraganglioma exist?

A

Chromaffin positive and non-chromaffin

46
Q

In chromaffin positive paraganglioma, what can the sympathetic nervous secrete?

A

Chatecholamines

47
Q

Where do chromaffin positive paragangliomas usually occur?

A

Adrenal medulla or paravertebral

48
Q

Where are some areas where non-chromaffin paragangliomas are likely to occur?

A

Carotid/aortic bodies, nose, nasopharynx, larynx, orbit

49
Q

What age group is most likely to be affected by non-chromaffin paraganglioma?

A

Can occur at any age but most commonly > 50

50
Q

Non-chromaffin paraganglioma can occur as part of what genetic condition?

A

MENII

51
Q

If non-chromaffin paraganglioma is inherited, how does this occur? How is it more likely to present?

A

Autosomal dominant- usually multiple and a higher chance of being malignant

52
Q

What is the major cancer of the head and neck? What are the major risk factors for this?

A

Squamous cell carcinoma- smoking and alcohol

53
Q

Squamous cell cancers associated with HPV are most likely to be where? What type of HPV is most commonly the cause?

A

Oropharynx / Type 16

54
Q

How does HPV cause squamous cell carcinoma?

A

Produces E6 and E7 proteins which disrupt p53 and Rb respectively

55
Q

What is sialolithiasis?

A

Salivary gland stones

56
Q

What does paramyxovirus cause?

A

Mumps causing bilateral parotitis

57
Q

Which salivary gland is the most common site for tumours?

A

Parotid

58
Q

Are tumours in smaller salivary glands more likely to be benign or malignant?

A

Malignant

59
Q

If someone is young and presenting with a painful mass in a salivary gland, what should you be thinking about?

A

Malignancy

60
Q

What is the most common tumour of a salivary gland?

A

Pleomorphic adenoma

61
Q

A pleomorphic adenoma can occur in anyone at any age, but what is the most common presentation?

A

Females > 60 in the parotid gland with a long history

62
Q

What is the risk of malignant transformation with a pleomorphic adenoma?

A

There is a risk if it is longstanding

63
Q

Warthin’s tumours of the salivary glands are most likely to affect who?

A

Males > 50

64
Q

Warthin’s tumours are rare outside which salivary gland? They have a strong association with what?

A

Rare outside the parotid- strong association with smoking

65
Q

What is the most common malignant tumour of the salivary glands in the UK?

A

Adenoid cystic carcinoma

66
Q

Adenoid cystic carcinoma is the most common tumour of where?

A

The palate

67
Q

A Mickey Mouse like cell is most likely to be what?

A

Eosinophil

68
Q

A round, dark purple cell with no cytoplasm is most likely to be what?

A

Lymphocyte

69
Q

A tumour producing keratin is most likely to be what?

A

SCC

70
Q

What cell signifies acute inflammation?

A

Neutrophil

71
Q

What cells signify chronic inflammation?

A

Lymphocytes and macrophages

72
Q

On histology, areas which look like twiglets are most likely to be?

A

Fungi

73
Q

On histology, finger like projections are?

A

Papillomas

74
Q

What do darkening, shrinking cells on histology signify?

A

Necrosis

75
Q

HPV associated SCC in the tonsils will usually present in who?

A

A young, healthy individual

ENT (12 decks)

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