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ENT > Pathology > Flashcards

Pathology Flashcards

1
Q

what glands are in the auditory meatus and external canal

A

sebaceous and ceruminous glands

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2
Q

what lines the middle ear

A

columnar epithelium lined mucosa

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3
Q

what lines the eustachian tube

A

respiratory epithelium

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4
Q

what gland produce cerumen (ear wax)

A

ceruminonus glands

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5
Q

what lines the nasal vestibule

A

squamous epithelium (keratinised)

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6
Q

what lines the rest of the nose and nasal sinus (apart from the nasal vestibule- most anterior part of nose)

A

respiratory epithelium with sero negative glands

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7
Q

what is respiratory epithelium

A

pseudostratified ciliated columnar epithelium (with goblet cells)

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8
Q

what type of epithelium lines the throat

A

depends on site:

  • oropharynx stratified squamous
  • everywhere else respiratory
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9
Q

what makes up the oropharynx

A

tongue from the circumvallate papillae, posteriorly to the epiglottis, the tonsils, the associated pharyngeal walls, and the soft palate

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10
Q

what type of gland is the salivary gland

A

exocrine

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11
Q

describe the components of the salivary gland

A

acinar and ductular component
serous cells
mucinous component
peripheral myoepthelial cells

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12
Q

what organisms cause chronic otitis media

A

Pseudomonas Aeruginosa
Staph aureus
fungal

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13
Q

what would you worry about if there was chronic otitis media infection

A

a tumour

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14
Q

what are the complications of otitis media

A

can perforate tympanic membrane or spread to e.g. mastoid

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15
Q

what is a cholesteatoma

A

not a tumour
lesion made of keratin in the middle ear caused by inflammation (chronic otitis media and perforated tympanic membrane) creating high cell turnover
can erode surrounding structures so need to be removed

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16
Q

what is the normal lining of the middle ear

A

cuboidal or columnar glandular epithelium

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17
Q

what is a vestibular schwannoma

A

an acoustic neuroma

most common tumour of the temporal bone

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18
Q

what are the symptoms of a vestibular schwannoma

A

hearing loss, tinitis, loss of balance, headaches, can grow and compress brain, brain stem

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19
Q

what nerve are vestibular schwannomas associated with

A

vestibular portion of the CN VIII

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20
Q

what should you suspect in young patients with bilateral vestibular schwannomas

A

neurofibromatosis type 2

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21
Q

what do vestibular schwannomas look like

A

will circumscribed, white/tan/yellow mass

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22
Q

what are the features of neurofibromatosis type 2

A 
autosomal dominant 
mutation in tumour suppressor gene 
neurofibromas 
bilateral vestibular schwannomas
multiple meningiomas 
gliomas 
cafe au lait spots 
cataracts
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23
Q

what are the causes of rhinitis and sinusitis

A

infections- cold, viral, bacterial

allergy- hay fever

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24
Q

who gets nasal polyps

A

not children

equal in both genders

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25
Q

what can cause nasal polyps

A

allergy, infection, asthma, aspirin sensitivity, nickle exposure

26
Q

what should you consider in a young patient with nasal polyps

A

cystic firbosis

27
Q

what is granulomatosis with polyangitis

A

autoimmune disorder
small vessel vasculitis and necrosis
usually limited to the respiratory tracts and kidneys

28
Q

how dors granulomatosis with polyangitis present

A

pulmonary, renal disease (haematuria, glomerulonephritis, hypertension), nasal symptoms (congestion, septal perforation)

29
Q

what is in high levels in GPA

A

ANCA +ve

multinucleated giant cells

30
Q

what is cANCA associated with

A

GPA

31
Q

what is pANCA associated with

A

microscopic polyangitis

32
Q

what is the most common malignant tumour of the nose

A

squamous cell carcinoma

can also get adenocarcinomas, nasopharyngeal carcinomas, neuroblastomas, lymphomas

33
Q

what benign tumours do you get in the nose

A

squamous papillomas, scheiderian papillomas, angiofibromas

34
Q

what is a schneiderian papilloma

A

benign nasal tumour
patients over 50, more common in males
presents with a blocked nose

35
Q

what are the causes of a schneiderian papilloma

A

HPV, smoking, organic solvents, welding

36
Q

what are the types of schneiderian papilloma

A

inverted and oncocytic (on lateral walls and paranasal sinuses)
exophytic (nasal septum)

37
Q

what does a nasopharyngeal carcinoma have a strong association with

A

esptein barr virus + volatile nitrosamines in food

occupation and family history

38
Q

what are the types of nasopharyngeal carcinoma

A

keratinising SCC or non keratinising

39
Q

how does epstein barr virus cause carcinogenesis

A

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

40
Q

what are laryngeal polyps

A

Reactive change in laryngeal mucosa secondary to - vocal abuse, infection and smoking. Occ. in hypothyroidism (due to oedema build up).

41
Q

what is a contact ulcer

A

benign response to injury

e,g, chronic throat clearing, voice abuse, GORD, intubation

42
Q

who gets squamous papiloma/papillomatosis

A

<5 years and between 20-40 years

related to HPV exposure

43
Q

what is a paraganglioma

A

Tumours arrising in clusters of neuroendocrine cells

can be chromaffin positive or negative

44
Q

what are squamous cell carcinomas in the head and neck associated with

A

smoking, alcohol, HPV

45
Q

how do you diagnose SCC

A

need to see keratinisation and pickle cells on biopsy

46
Q

what are sialolithiasis

A

stones of the salivary glands

47
Q

what infections can you get in the salivary glands

A

paramyxovirus (mumps)

48
Q

where is the most common site for all salivary gland tumours

A

parotid

49
Q

what salivary gland tumours are more likely to be malignant

A

those in the smaller glands

50
Q

what should a young patient with a painful salivary gland mass make you think

A

malignancy

51
Q

what is a pleomorphic tumour

A

most common salivary gland tumour- risk of malignant transformation, usually in parotid

52
Q

what is a warthins tumour

A

benign tumour of the salivary glands associated with smoking

53
Q

what is the most common malignant tumour of the salivary glands

A

adenoid cystic carcinoma

outside of uk most common mucoepidermoid carcinoma

54
Q

what is an adenoid cystic

A

most common malignant tumour of the palate

55
Q

what is the histology of nasal polyps like

A

resp epithelium on surface

lots of inflammatory cells inside

56
Q

what is aspergillis

A

a ball of fungus found in a single lung cavity - which may improve or disappear, or change very little over a few years. Chronic cavitary pulmonary aspergillosis (CCPA) where cavities are present in the lungs, but not necessarily with a fungal ball (aspergilloma)

57
Q

what tumours are associated with ebstein barre virus

A

Burkitt’s lymphoma. B-cell lymphoproliferative syndromes, and nasopharyngeal carcinoma
with Hodgkin’s disease, T-cell lymphomas, and gastric carcinoma, as well as being the causal agent for infectious mononucleosis.

58
Q

what is a histiocyte

A

a stationary phagocytic cell present in connective tissue

59
Q

what covers the vocal chords

A

stratified squamous epithelium

60
Q

what virus is squamous cell carcinoma associated with

A

HPV types 6 and 11

61
Q

what do paragangliomas look like

A

nested appearance

62
Q

what do parotid glands look like histologcally

A

very serous

ENT (27 decks)

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