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CPR 2 Exam 2 > Pathology Of The Respiratory System PART 2 - Dr. Singh > Flashcards

Pathology Of The Respiratory System PART 2 - Dr. Singh Flashcards

1
Q

Age most high prevalence of pneumonia needing hospitalization

A

18-64yo
= can cause sepsis and shock
Leading cause of death in children under 5yo

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2
Q

Bronchopneumonia vs lobar pneumonia

A

Bronchopneumonia: spread through airway and effect areas that airway goes to
Lobar pneumonia: effects the lobe

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3
Q

4 stages of lobar pneumonia

A
  1. Congestion : due to Blood buildup and
  2. Red Hepatization : inflammatory cells and RBCs going into alveolar space (filling with blood) ——> looks like a red liver
  3. Grey Hepatization : inflammation and debri is left , Blood leaves side no more inflammatory cells needed) ——> looks like a grey liver
  4. Resolution : M clean and some fibrosis
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4
Q

3 complications of Lobar pneumonia

A
  1. Abscess (c shaped or circular wall white , inside is white on bottom with air-fluid line on CXR)
  2. Empyema (bacteria invading into pleural space)
  3. Baceremia (bacteria invade into BVs)
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5
Q

What are the community acquired bacterial pneumonia MOST common and some others

A
  1. Streptococcus Pneumonia
  2. H. Influenzae
  3. S. Aureus
  4. K. Pneumoniae
  5. P. Aeruginosa
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6
Q

Streptococcus Pneumonia looks like Ab

A

Gram + diploccoi (pairs in chains) looks like a spear head
= most common community acquired pneumonia
= vaccines are given in > 65yo

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7
Q

Haemophilus influenzae Pneumonia

A

Bacteria with high virulence in children

Vaccine in children under 5yo

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8
Q

Steph Aureus

A

Abscess formation in lung

IV drug users

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9
Q

Klebsiella Pneumonia

A

Alcoholics ——> aspirations

Current Jelly Sputum (hemorrhage + mucous = coughed up)

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10
Q

Viral influenza in children

A

Cause bacterial haemophilus influenza to come and is what actually causes fatal SXs

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11
Q

Pseudomonas Aeruginosa who, and associated with

A

Another CAP
= CF are prone to it usually by age 10yo
= green rusty looking, grape like smell

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12
Q

Typical pneumonia

A

= fast onset
= resp sx
= consolidation on a lobe seen on CXR
= children and older adults

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13
Q

Atypical Pneumonia

A

= slow onset
= systemic SXs
= patchy infiltrates on CXR
= young adults, teens, older children

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14
Q

Typical pneumonia microorganisms

A
  1. Strep Pneumonia
  2. H. Influenza
  3. S. Aureus
  4. K. Pneumonia
  5. P. Aeruginosa
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15
Q

Atypical Pneumonia microorganisms

A
  1. Mycoplasma Pneumonia
  2. Legionella Pneumophilia
  3. Chlamydia pneumonia
  4. Chlamydia Psittaci
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16
Q

Mycoplasma Pneumonia looks like and what it does

A

Small tiny no cell wall organisms that can travel down far in the airway
= walking pneumonia
= no gram charge

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17
Q

Legionella Pneumophilia type of organism and where it is found

A 
Gram - bacillus growing in WARM FRESH WATERS 
= air conditions 
= Misters
= Hot Tubs 
(Airborne)
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18
Q

Community - Acquired Viral pneumonia 4 of them

A
  1. H1N1 Influenza
  2. SARS
  3. COVID-19
  4. Respiratory Syncytial Virus
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19
Q

Viral pneumonia doesn’t what usually on CXR

A

Diffuse and all over usually not lobar and in one space

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20
Q

Bacterial pneumonia does what to lung tissue

A

Destruction of lung parenchyma and infiltration on N and many RBCs into alveolar space

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21
Q

Viral Pneumonia does what to lung tissues

A

Lymphocytes and plasmacytosis into interstitial spaces all around the alveoli

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22
Q

2 proteins of the Influenza

A
  1. Hemagglutinin = attachment to cells
  2. Neuraminidase= release of virus from cell and replication
    = these are the variants between the strains
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23
Q

Tamiflu is what

A

Oseltamivir
= BLOCKS Neuraminidase (cutting virus off the cell to go one a bind and replicate on other cells)
= the Haemagglutinin is stuck on the cell

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24
Q

Influenza SX

A

Body aches, chills, headache, fever, fast onset = which is not seen as much in colds

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25
Q

Antigenic SHIFT vs Antigenic DRIFT in influenza

A

SHIFT : EPIDEMIC , minor changes in neuramidase and haemugglutin proteins
= you still have some immunity
DRIFT : PANDEMICS , huge genomic alterations in H and N proteins and creates a virus that is completely new to body
= usually from animals

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26
Q

H1N1 influenza caused what

A

Antigenic drift causing the Spanish Flu ( from bird)
H2N2 = Asian flu
H3N2 = Hong Kong flu

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27
Q

Fastest replicating virus is what type of route and which dies ease is it linked to

A

ssRNA +

= SARS and COVID -19 (SARS-Co-2)

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28
Q

COVID-19 enters body how and what happens

A

Binds to ACE2 Receptors in gut and lungs

  1. Cytokines storm
  2. Damage and pulmonary edema (ALSO IN ARDS)
  3. DVT prone pts —> PE
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29
Q

COVID lung histology

A

Hyaline membrane from fibrin and edema and inflammation
= alveoli fill up with cells and blood (like in bacterial pneumonia——> it came from COVID) as seen in viral influenza in children

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30
Q

Coagulation in lungs for COVID

A

Microthrombi in lungs = deadly
Megakaryocytes (not supposed to be in circulation however cause platelets microcoagulation in COVID) ——> microthrombi in heart and lungs and other vessels in the body

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31
Q

Neonatal most common pneumonia

A

Bacterial (Group B Streptpcoccal, gram - bacilli, Listeria)

= from mother

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32
Q

Children over 1mo most common pneumonia

A

VIRAL : Respiratory Syncytial Virus, Parainfluenza influenza A + B, Adenovirus, Rhinovirus
BACTERIAL : Strep Pneumonia, H. Influenzae, M. Catarrhalis, S. Aureus

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33
Q

Older children and adolescents most common type of pneumonia

A

M. Pneumonia , C. Pneumonia (Walking pneumonia)

= not as much RSV

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34
Q

Groups of Strep for diseases

A

Group A Streptococcus Pharyngitis : Rheumatic Fever
Group A B-Hemolytic Streptococcus : Lymphangitis
Group B Streptococcus : Neonatal Pneumonia

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35
Q

RSV type of virus and looks like

A

Paramyxovirus

= multinucleated (inclusion bodies inside)

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36
Q

RSV SX

A 
Babies come in with
= cough, runny nose
= wheezing, dyspnea
= Tachy
= cyanosis
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37
Q

RSV what happens in the lung

A

Thickening of walls of bronchus and mucous buildup

= damaging respiratory epithelium

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38
Q

What can also look like the multinucleated syncytial bodies in RSV

A

Human Metapneumovirus
Parainfluenza
Measles

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39
Q

Presentations of BACTERIAL PNEUMONIA 5

A
  1. Fast onset, not airborne unless (Legionella or Pertussis), not easily spread as much
  2. HIGH FEVER
  3. Crackles in lung
  4. Lobar Consolidations seen
  5. Can go into pleura
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40
Q

Presentations of VIRAL PNEUMONIA 6

A
  1. Slow onset
  2. Commonly spread easily (airborne)
  3. Low fever
  4. Wheezes in lung
  5. Diffuse infiltration in CXR
  6. Not usually in pleural cavity
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41
Q

Which microorganisms can cause lung abscess

A
  1. S. Aureus
  2. K. Pneumonia
  3. Anaerobic bacteria (since they like to get walled off)
    (Also in chronic alcoholism —> aspirations)
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42
Q

lung abscess most common location

A

Right middle or lower lobes (after carina the slope of RIGTH bronchus is more steep)
(CLASSIC ASPIRATION PNEUMONIA)

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43
Q

TB infection Primary lesion is called what

A

Ghon complex = 1st caseating complex (in the periphery and hilum that it’s connected to) of the lung

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44
Q

Miliary TB

A

As TB gets access to the Blood stream they disseminate and go the liver and spleen

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45
Q

Ceseating granuloma has what special cells around the granuloma and how do you stain for this and what do you seen in the stain

A

Giant multinucleated cells

Acid Fast : blue background and red/purple lines

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46
Q

4 causes of granulomas in the lung

A
  1. TB
  2. Sarcoidosis
  3. Hypersensitivity pneumonia
  4. Vasculitis (GPA)
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47
Q

Chronic Pneumonia most common fungal causes

A

Histoplasma
Blastomycosis
Coccidiomycosis

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48
Q

Histoplasma where and what does it do

A

Midwest and Caribbean (ohio, Mississippi River valley)
= in lungs granulomas form ——> calcifications and coin lesions in cxr, however no real sx
= can be aggressive in immunocompromized (chronic pneumonia)

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49
Q

Histoplasma looks like what on histology

A

Pumpkin seeds

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50
Q

Blastomyces dermatitides location and what does it do

A

Central and SE US (Ohio, Mississippi River valley)
= granulomas in lung
= can infect skin
= immunocompromized can get chronic pneumonia

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51
Q

Blastomyces dermatitides looks like what on histology

A

Broad Based Budding (2 circles that look like they are budding that are tightly attached to each other)

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52
Q

Coccidiodes immitis location and what does it do

A

SW US and Mexico
= lung granulomas + high Eosinophils
= self -limited pneumonia
= can become disseminated infection esp immunocompromized

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53
Q

Coccidiodes immitis looks like what

A

Perfect round circle with a bunch of smaller circles inside it (plasmocytes)

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54
Q

Most common pneumonia causes in HIV patients

A 
Pneumocystis Jiroveci (carinii) 
CMV
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55
Q

Pneumocystis Jiroveci is what and what happens

A

Fungal infection
= AIDS get pneumonia
= very elderly and immunocompromized pts can also

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56
Q

Pneumocystis Jiroveci looks like what on histology

A

Cup shaped yeast

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57
Q

Cytomegalovirus is what and does what and what it looks like on histology

A
  1. Viral infection = Bid Cell Virus
  2. Pneumonia in immunocompromized
  3. Cowdry image (like an eyeball, one of the owl eyes, you see virus in nucleus + cytoplasm)
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58
Q

Mycobacterium Adium Complex (MAC) is what and stain for it

A

Immuocompromized and pneumonia

= mycobacterium in acid fast stain

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59
Q

After transplantation of lungs how can you see if they are rejecting the lungs or infection of lungs

A

REJECTION = mononuclear infiltrates of lymphocytes = give steroids
INFECTION fungal or viral = you see the organism = treat that and lower steroids

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60
Q

Lung cancer is associated with what

A 
= tobacco smoking
= Radiation 
= uranium 
= asbestos 
= radon
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61
Q

Gene protecting from lung cancer

A

Polymorphism in P450 (DNA repair genes)

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62
Q

SCC effects what cells in the lung and what genes are associated with it

A

Basal cell——> ciliated cells (Bronchous most proximal)

SOX2, NOTCH, CDKN2A

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63
Q

Small Cell carcinoma effects what cells in the lung and what genes are associated with it

A

Neuroendocrine cells (thought out the respiratory epithelium)
= TP53
=RB1

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64
Q

Adenocarcinoma effects what cells in the lung and what genes are associated with it

A

Type 2 alveolar cells
= EGRF-RAS pathway (K-RAS, B-catenin)
= sometimes p53 also

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65
Q

Smoking usually cause what lung cancers

A

SCC

Small Cell Carcinoma

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66
Q

Most common lung cancer

A

Adenocarcinoma

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67
Q

Adenocarcinoma first stage and what is the characteristics of this stage

A

Atypical Adenomatous Hyperplasia (AAH)
= <5mm, dysplastic pneumocytes present in alveoli
= some interstitial fibrosis

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68
Q

Adenocarcinoma second stage and what is the characteristics of this stage

A

Adenocarcinoma in situ (AIS)
= <3cm bronchioalveolar carcinoma
= dysplastic pneumocytes growing along alveoli (making a wall)

69
Q

Adenocarcinoma 3rd stage and what is the characteristics of this stage

A

Pulmonary Adenocarcinoma
= metastatic glands
= most common type of lung cancer in smokers and non-smokers
= IDENTIFY THIS since it has a treatment

70
Q

Pulmonary Adenocarcinoma dx

A

Stain with + TTF-1

71
Q

Mutinous Adenocarcinoma what is it and it looks like what

A

Grow along the wall of the alveoli however longer then in AIS
= can look exactly like pneumonia on CXR
= deadly pneumonia

72
Q

SCC stages and each stage looks like after cilia have been destroyed

A
  1. Squamous Metaplasia : basal layer is abnormal only then the flat cells on top are normal
  2. Squamous Carcinoma in Situ : all cells are round and abnormal more vertical looking
  3. Squamous invasive
73
Q

How to identify SCC on histology

A

Keratin pearls (pink pearl with swollen big cells inside and around it)

74
Q

SCC on cytology

A

Orange cytoplasm = keratin

= Big cells

75
Q

SCC prevalence and location

A

Men, smokers,

= centrally locations more from the airways

76
Q

TNM

A 
T = tumorsize
N = LNs involved
M = metastasis to how many distant locations
77
Q

Most common SX of lung tumor

A
  1. cough
  2. Hemoptysis
  3. Chest pain
  4. Pneumonia = (tumor invading airway) look at CT scan if smoker
  5. Hoarseness = recurrent laryngeal nerve invasion
78
Q

Small cell neuroendocrine carcinoma prevalence and what it does

A

= heavy smokers and older pts
= very deadly (5% 5 year survival)
= can metastasize to brain and neural involvement

79
Q

Small cell carcinoma histology looks like what

A

nuclear molding = crowding of cells into like a subway look (looks like nuclei combining and making a rocket ship)
= a lot of necrosis
= many blue nuclei crowing

80
Q

Small cell carcinoma TX

A

Surgical excision only if not reached LN

Chemo and radiation = high response only high recurrence rate

81
Q

Small cell carcinoma DX

A
  1. Nuclear molding + necrosis
  2. Neural involvement if that sage has happened
  3. CD56 for all neurocarcinomas
82
Q

Adenocarcinoma TX (dont need to know specific pathways and drugs)

A

Molecular Testing

  1. EGFR (HER1 receptor) BLOCKER of receptor for this pathway (ERLOTINIB)
  2. ALK-EML4 BLOCKER of the gene fusion (Crizotinib)
  3. PDL-1 (block tumor from evading immune system with CTLA4 or PD1) (PEMBROLIZUMAB)
83
Q

What to look for when TX Adenocarcinoma

A
  1. EGFR unregulated pathway expression yes or no
  2. ALK rearrangement yes or no
  3. PD-1 expression (getting away from immune system)
  4. CTLA-4 expression (getting away from immune system)
84
Q

SCC and agents for tx

A

Don’t use VEGF inhibitors = They can bleed due to their location so close to BVs

85
Q

SSC Paraneoplastic syndrome it is associated with

A

PTH release causing HYPERCALCEMIA = mental changes and EKG changes

86
Q

Small cell carcinoma paraneoplastic syndromes it is associated with

A
  1. ADH secretion = SIADH (weakness, confusion, hyponatremia)

2. ACTH secretion = Atypical Cushing Syndrome (non obese, striae since it’s so fat onset), edema, HTN, hyperglycemia)

87
Q

Horners Syndrome is what

A

Apex of lung tumor that invades into sympathetic trunk = oculosympathetic palsy

88
Q

Horners Syndrome sx

A
  1. Enophthalmos = sunken eyeball
  2. Ptosis = drooping eyelid
  3. Miosis = constricted pupil
  4. Anhydrosis = no sweating on that side of the face
  5. Arm parasthesia = pain, wasting in arm due to brachial plexus constriction
89
Q

4 Neuroendocrine tumors

A
  1. Small cell carcinoma
  2. Carcinoid tumor
  3. Atypical Carcinoid tumor
  4. Precursor Lesion : DIPNECH (Diffuse Interstitial Pulmonary Neuroendocrine Cell Hyperplasia)
90
Q

DIPNECH is what and how to see this

A

= high resolution CT needed
= very small nodules < 5mm (hyperplasia)
= NOT risk factor

91
Q

Carcinoid tumor is what

A 
5mm < *
Can metastasize (in lung and SI), Grade 1
92
Q

Carcinoid Tumor histology

A

Larger tumor with Neuroendocrine cells (round with purple cytoplasm)

93
Q

Atypical Carcinoid tumor

A

Grade 2*
1. grow fast (the Neuroendocrine purple round cells)
2. Necrosis (pink spots)
= higher change to metastasize

94
Q

Grade 3 Neuroendocrine carcinoma

A

Small cell carcinoma

95
Q

Carcinoid syndrome

A

Any grade Neuroendocrine carcinoma can give you this (also seen in GI)

  • flushing
  • D
  • Cyanosis
96
Q

5 year survival grade 1,2,3

A

Carcinoid tumor = 95%
Atypical carcinoid tumor = 70%
Small Cell carcinoma = 5%

97
Q

Multiple huge tumors all over lungs seen on CT scan what do you suspect

A

Not primary tumor

= metastatic from other place (testicular, melanoma) even in young pts

98
Q

Pulmonary hamartoma what Is it and risk + CT Scan

A

Benign
= ball of hyaline cartilage and mixed cells
= coin lesion on CT

99
Q

Lymphangioleiomyomatosis (LAM) what is this

A

= perivascular epithelioid cell growth (PEC-oma)

= crest cystic spaces

100
Q

Lymphangioleiomyomatosis (LAM) associated with what

A

Tuberous sclerosis

101
Q

Lymphangioleiomyomatosis (LAM) DX + gene

A

Stain with melanoma markers = HMB-45

= loss of function of TSC2 gene

102
Q

Lymphangioleiomyomatosis (LAM) prevalence

A

Young women

103
Q

Lymphangioleiomyomatosis (LAM) risks

A

The cystic spaces that are made grow and expand so much they can cause pneumothorax

104
Q

pleural effusion of CT

A

You see fluid on the posterior side since they are laying down

105
Q

Transudate pleural effusion what and exs

A 
FLUID ONLY
= higher hydrostatic p 
1. HF
2. Nephrotic syndrome 
3. Cirrhosis
106
Q

Exudative Pleural effusion what and exs

A

PROTEIN FLUID CELLS (inflammation)

  1. PE
  2. Lung infection
  3. Lung malignancy
  4. CT problem (SLE, RA)
  5. Pancreatitis
107
Q

Bloody effusion from pleural effusion

A

Metastatic cancer

108
Q

Transparent effusion from pleural effusion

A

Left HF

109
Q

Milky white effusion from pleural effusion

A

Bronchogenic carcinoma obstructing the thoracic duct or any other cause of thoracic duct obstruction

110
Q

Empyema

A

Can happen from inflammation BACTERIAL = thick and pussy exudate (Webs of trapped fluid = LOCULATIONS)

111
Q

Empyema tx

A

Surgery to clear the loculations so fluid can be cleared and tx works

112
Q

Spontaneous pneumothorax cause and prevalence

A

Usually younger pts

= rupture of subpleural blebs ——> introducing air into pleural space

113
Q

Secondary Pneumothorax what are causes 4

A
  1. Cystic infection (PCP = pneumocystis pneumonia)
  2. Cystic tumor
  3. Positive Pressure ventilation
  4. Trauma
114
Q

Tension Pneumothorax

A

Injury to chest wall causing in air to flow into pleural space every time you inspire only it cant get out (since you expand your chest when you inhale) = more and more air comes in to pleural space ——> pushes all other organs aside

115
Q

Tension pneumothorax tx

A

Stick a needle in (needle decompression) and the air flows out

116
Q

Solitary Fibrous Tumor what is it and histology

A

TUMOR IN PLEURAL CAVITY
Fibroblast tumor = benign (small and pendunculated)
= staghorn looking

117
Q

Solitary fibrous tumor risks

A

Can get really large and behave like sarcomas

118
Q

Solitary Fibrous Tumor tx and stain

A

CD34

Remove them since they are benign

119
Q

Mesothelioma associated with what and who

A 
TUMOR IN PLEURAL CAVITY, can invade into lung 
Asbestos exposure 
= shipworker, steam pipes
= construction worker, insulation’s 
Can happen decades after exposure
120
Q

Types of Mesothelioma and stain

A

Epithelioid, sarcomatoid, mixed , STAIN CALRETININ

In TTF-1 —> adenocarcinoma

121
Q

Mesothelioma histology you can see

A

Looks like Adenocarcinoma with glands and cells

+ you can see ferruginous bodies (asbestos bodies)

122
Q

Mesothelioma TX

A

Most pts don’t survive 2years, not responsive to chemo or radiation as much, can’t be removed surgically

123
Q

Inflammatory Sinonasal Polyps are what

A

Edema (infectious) OR Eosinophilis (allergic) in polyp of the stroma
= histology is light color

124
Q

2 ways to obstruct the nasals cavity

A
  1. Empyema : mucous and bacterial secretions accumulate obstructing
  2. Mucocele : mucous secreting glands forms and secrete purulent material in the cavity made
125
Q

Bacterial sinusitis of maxillary sinus can happen how

A

From oral flora from dental procedures

126
Q

Ethmoid sinusitis can cause what

A

Periorbital cellulitis

127
Q

Frontal sinusitis can cause what

A
  1. Meningitis

2. Epidural abscess, brain abscess, subdural abscess

128
Q

Allergic Fungal sinusitis

A

Aspergillus that causes allergic type reaction when it enters nasal cavities
Eosinophils come and try to get rid of them —> Chacoidlinar crystals form

129
Q

Aspergillosis can cause what

A

Mycetoma = fungal ball (you see acute angle sepae

130
Q

Acute invasive sinusitis who and from what

A

Zygomycosis (Murcor)
DM or immunocompromized
= EMERGENCY IV TX

131
Q

Acute Invasive sinusitis can cause what and to and what does it look like on histology*

A

Spread to brain or sepsis
= IV Anti-fungals
= deadly
= non-septal hyphae**

132
Q

GPA (granulomatosis with Polyangiitis (Wagner’s) sx subtle

A
  1. Nasal ulceration or necrosis or perforations

2. Can effect kidneys and lungs

133
Q

GPA histology

A

Necrobiotic necrosis : blue (blast of inflammation killing all vascular cells)

134
Q

Nasopharyngeal Angiofibroma what is it and histology

A

Polyploid mass growing in nasal tissue

HIST : penile tissue resembling, fibrous + vascular polyp

135
Q

Nasopharyngeal Angiofibroma what can happen and associated with

A

bleeding + recur however is benign

= Familial Adenomatous Polyposis* (Adenomatous polyps in colon —> carcinoma by middle age, APC gene), IN YOUNG PTS

136
Q

Nasopharyngeal Angiofibroma prevalence

A

Young fair skin and light hair / red hair males

137
Q

Sinonasal (SCHNEIDERIAN) Papilloma prevalence and associated with

A

Middle age men

HPV

138
Q

Sinonasal (SCHNEIDERIAN) Papilloma 3 types

A
  1. Exophytic : grows outward
  2. Endophytic : grows inward and can become a carcinoma *
  3. Oncocytic : cells are different type
139
Q

Olfactory neuroblastoma histology and prevalence

A

Small round blue tumor cells (Roset formation can happen kind of like a bulls eye looking thing with light pink in middle the white around then blue cells around)

Adolescence and middle age (2 age peaks)

140
Q

Olfactory neuroblastoma is what

A

Neuroectoderm in superior nasal passage (Neuroendocrine tumor)
= malignant

141
Q

Olfactory neuroblastoma on CT

A

Dumb-bell shaped ( first grows down, then penetrates cribriform plate and grows up towards brain)

142
Q

Nasopharyngeal Carcinoma is what and sx

A

SCC from nasopharynx only no real sx

NECK LN metastasis —> when sx form very enlarged LN

143
Q

Nasopharyngeal Carcinoma risk factors and prevalence

A
  1. EBV*
  2. Chinese, Southeast Asian adults (smoked fish with nitrosamines)
  3. African children
144
Q

EBV is associated with what malignancies

A

Burkitts

Nasopharyngeal Carcinoma

Extranodal NK/T cell lymphoma

145
Q

EBV stain

A

EBER-1

146
Q

Vocal Cord Nodules are what

A

SINGERS NODULES
= edematous soft polyp on vocal cords
(Happens as a reactions, not true neoplasm) singers can get these

147
Q

Laryngeal squamous Papilloma what is it and location

A

Benign squamous neoplasm with small papillary masses on VOCAL CORDS and can extend down the airway
(RARE malignant forming)

148
Q

Laryngeal squamous Papilloma associated with what 2 things

A
  1. HPV 6 and 11

2. Recurrent respiratory papillomatosis

149
Q

Laryngeal squamous Papilloma can cause what

A

Cysts of air trapped in lungs

150
Q

Laryngeal squamous Papilloma prevalence

A

BABIES TO Mother’s under 20yo , vaginal delivery, 1st born (get HPV 6,11)
Adolescents , children

151
Q

Laryngeal carcinoma is what

A

SCC in larynx

152
Q

Laryngeal carcinoma prevalence and associated with what risks

A

Men over 60yo
= alcohol
= smoking
= HPV

153
Q

Laryngeal carcinoma looks like

A

Ulcerative lesion

154
Q

Otitis Media caused by what 3 organism

A
  1. Streptococcus pneumonia
  2. Moraxella Catarrhalis
  3. Haemophilus Influenza
155
Q

Chronic Otitis Media is caused by what and who

A

Pseudomonas Aeruginosa in DM

156
Q

Cholesteatoma happens how

A

Chronic otitis media causes cystic lesion that invaginate into the epithelium
= keratin gets trapped inside
= can enlarge and erode adjacent bone
= looks like a large zit in the ear

157
Q

Otosclerosis is what

A

Bony deposits in the stapedial footplate

158
Q

Otosclerosis sx and hesitance

A

Conductive hearing loss

AD (familal deafness)

159
Q

Otosclerosis tx

A

Remove the bone and replace it

160
Q

Brachial Cyst is what

A 
Stratified squamous (full of keratin) or respiratory epithelium cyst that forms from 2nd BRANCH ARCH during development 
=fibrous + lymphoid tissue
161
Q

Brachial Cyst location and prevalence

A

In front of sternocleidomastoid

Young adults

162
Q

Cystic lesion in adult and in children on the neck

A

ADULT : metastatic cystic carcinoma
CHILDREN : bronchial cyst on congenital
(Keratin debri inside is seen)

163
Q

Thyroglossal Duct Cyst is what

A

Thyroid tissue remnants from when it migrated

= changes into a cyst (nests)

164
Q

Thyroglossal Duct Cyst location

A

Anyplace on midline on neck from back of tongue

165
Q

Carotid Body Tumor what is this

A

NCC from autonomic paraganglia (Paravertebral paraganglia, phenochromocytoma (adrenal gland), vessels)
= involves the carotid body vessels and a tumor at the bifurcation of it**

166
Q

Carotid Body Tumor location and CT scan and associated

A

Bifurcation of carotid A = looks like of like Poseidon’s stick
= MEN2 (multiple endocrine neoplasia 2)

167
Q

Carotid Body Tumor histology and DX

A

Cobble stone looking = ZELLBALLEN (ball of cells)* = nests of cells
S-100 stain

168
Q

Carotid Body Tumor prognosis

A

15%-40% malignant and histology cant tell

CPR 2 Exam 2 (12 decks)

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