Pathology

Question 1

define otitis media

Answer 1

inflammation of the middle ear

Question 2

causes of otitis media

Answer 2

usually viral

can be bacterial e.g. strep pneumonia, H. influenza and moraxella catarrhalis

Question 3

causative organisms in chronic otitis media

Answer 3

pseudomonas
staph aureus
fungal

Question 4

presentation of cholesteatoma

Answer 4

pearly white masses in the ear, often the middle ear

Question 5

two types of cholesteatoma

Answer 5

acquired

congenital

Question 6

histological presentation of cholesteatoma

Answer 6

abnormal stratified squamous epithelium with abundant keratin

Question 7

management of cholesteatoma

Answer 7

lesions are usually scraped out

Question 8

what is a vestibular schwannoma associated with location wise?

Answer 8

vestibular portion of CNVIII

Question 9

where are vestibular schwannomas usually located?

Answer 9

inner ear within the temporal bone

Question 10

what to consider if young and bilateral vestibular schwannomas

Answer 10

neurofibromatosis II

Question 11

histology of vestibular schwannomas

Answer 11

well circumscribed
encapsulated
yellow benign

Question 12

define neurofibromatosis II

Answer 12

AD condition affecting the NF-2 gene (tumour suppressor) which encodes for the merlin protein

Question 13

presentation of neurofibromatosis II

Answer 13

neurofibromas
bilateral vestibular schwannomas
gliomas
cafe au lait patches
cataracts

Question 14

are nasal polyps common?

Answer 14

yes, but not in children

Question 15

causes of nasal polyps

Answer 15

allergy (eosinophils present)
infection
asthma
aspirin sensitivity
nickel exposure

Question 16

if young with nasal polyps what cause to consider?

Answer 16

CF

Question 17

what do sinonasal papilloma look like?

Answer 17

nasal polyps and they present the same way
can form micro-abscesses
presence of mucocytes is not normal (respiratory epithelium)

Question 18

define granulomatosis with polyangiitis

Answer 18

AI small vessel vasculitis that is limited to the respiratory tract (nose too) and kidneys

Question 19

who does GPA present in?

Answer 19

over 40s

Question 20

presentation of GPA

Answer 20

pulmonary
renal
nasal symptoms

Question 21

diagnosis of GPA

Answer 21

high ANCA (cANCA)

Question 22

benign tumours of the nose

Answer 22

squamous papilloma’s
Schneiderian papilloma’s
angiofibromas

Question 23

malignant tumours of the nose

Answer 23

squamous cell carcinomas
adenocarcinomas
nasopharyngeal carcinomas
neuroblastomas
lymphomas

Question 24

three types of Schneiderian papilloma’s

Answer 24

inverted (lateral nasal wall)
exophytic (nasal septum)
oncocytic (lateral nasal wall)

Question 25

who does Schneiderian papilloma's present in?

Answer 25

tend to be over 50 | males

Question 26

causes of Schneiderian papilloma's

Answer 26

HPV6 and 11 (low risk) smoking organic solvents welding

Question 27

presentation of Schneiderian papilloma's

Answer 27

blocked nose

Question 28

associations with nasopharyngeal carcinoma

Answer 28

male EBV nitrosamines in food

Question 29

two types of nasopharyngeal carcinoma

Answer 29

keratinising (less of a link with EBV) | non-keratinising (EBV)

Question 30

what is EBV associated with (tumours)

Answer 30

Burkitt's lymphoma other B cell lymphomas Hodgkin's lymphoma

Question 31

what cells does EBV infect?

Answer 31

epithelial cells of oropharynx and B cells

Question 32

define laryngeal polyps

Answer 32

reactive change in the mucosa

Question 33

causes of laryngeal polyps

Answer 33

vocal abuse infection smoking

Question 34

histology of laryngeal polyps

Answer 34

stratified squamous epithelium (+ulcer)

Question 35

what condition can laryngeal polyps be seen in?

Answer 35

hypothyroidism

Question 36

define contact ulcer

Answer 36

benign response to injury

Question 37

where are contact ulcers usually found

Answer 37

posterior to vocal cord

Question 38

causes of contact ulcer

Answer 38

chronic throat clearing voice abuse GORD intubation

Question 39

peak age related incidences of squamous papilloma

Answer 39

<5 | 20-40 year olds

Question 40

what is squamous papilloma related to?

Answer 40

HPV 6 and 11

Question 41

histology of squamous papilloma

Answer 41

stratified squamous epithelium often with keratin that is thicker than normal

Question 42

define paragangliomas

Answer 42

tumours arising in clusters of neuroendocrine cells

Question 43

locations of chromaffin positive paragangliomas

Answer 43

adrenal medulla | paravertebral

Question 44

location of crhomaffin negative paragangliomas (no catecholamines secreted)

Answer 44

aortic carotid bodies oral cavity nose

Question 45

what age group get paragangliomas

Answer 45

over 50s

Question 46

what is paragangliomas associated with?

Answer 46

MEN2

Question 47

how to diagnose HPV associated carcinomas?

Answer 47

DNA check- PCR or in-situ hybridisation

Question 48

salivary glands in the head and neck

Answer 48

parotid submandibular sublingual minor salivary glands

Question 49

define sialolithiasis

Answer 49

stones

Question 50

infections of the salivary glands causes

Answer 50

paramyxovirus (mumps, parotitis, orchitis and pancreatitis, risk of secondary meningitis)

Question 51

four types of salivary gland tumours

Answer 51

1. pleomorphic adenoma (benign) 2. Warthin's tumour (benign) 3. mucoepidermoid carcinoma (malignant) 4. adenoid cystic (malignant)

Question 52

describe pleomorphic adenoma

Answer 52

``` most common parotid females 40-60 risks malignant transformation well-circumscribed tumours that tend to be encapsulated ```

Question 53

describe Warthin's tumour

Answer 53

``` usually males over 50 rare outside the parotid associated with smoking often bilateral columnar cell and cystic lesions lymph node appearance ```

Question 54

describe mucoepidermoid carcinoma

Answer 54

majority in parotid

Question 55

describe adenoid cystic

Answer 55

over 40 usually parotid most common malignant tumour of the palate frequent perineural invasion (associated with pain and loss of function)