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Respiratory Pathology - 6 (Nasopharynx) Flashcards

1
Q

The nose, nasopharynx and paranasal sinuses are lined by what type of epithelium?

A

Respiratory type

  • ciliated and goblet cells
  • mucous glands
  • lymphoid aggregates
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2
Q

Rhinitis

A

Inflammation of the nose

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3
Q

Sinusitis

A

Inflammation of the sinus

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4
Q

Rhinorrhea

A

Runny nose

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5
Q

What 4 viruses are commonly the cause of Viral Rhinitis/Sinusitis?

A

Rhinovirus
Adenovirus
Coronavirus
Echovirus

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6
Q

Symptom of Viral Rhinitis/Sinusitis?

A

Clear rhinorrhea

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7
Q

What is usually superimposed on a viral rhinitis/sinusitis?

A

Bacterial rhinitis/sinusitis

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8
Q

What 2 bacteria are commonly the cause of a superimposed bacterial rhinitis/sinusitis?

A

Streptococcus Pneumoniae

Haemophilus Influenzae

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9
Q

Symptom of Bacterial Rhinitis/Sinusitis?

A

Thick and purulent nasal discharge

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10
Q

Allergic Rhinitis/Sinusitis can be from a variety of inhaled allergens. What type of hypersensitivity reaction is it and what cells are present?

A

Type 1 Hypersensitivity

= EOSINOPHILS and inflammatory infiltrate

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11
Q

Symptoms and cellular infiltrate of Allergic Rhinitis/Sinusitis?

A

Edema and Rhinorrhea

– Eosinophils and inflammatory cells

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12
Q

What can Infectious and/or Allergic Rhinitis/Sinusitis turn into?

A

Chronic Rhinitis/Sinusitis

–> Inflammatory Sinonasal Polyps

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13
Q

Histologic manifestations of Inflammatory Sinonasal Polyps?

A
  • Edema in stroma

- EOSINOPHILIC infiltrates

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14
Q

Histologic manifestations of Inflammatory Sinonasal Polyps?

A
  • Edema in the stroma

- EOSINOPHILIC infiltrates

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15
Q

Sinusitis that involves an obstruction can potentially lead to what 2 things?

A
  • Mucocele

- Empyema

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16
Q

What is the pathway of infection for Sinusitis?

A
  • Pathogen tracks along periapical tissues (oral flora)
  • Enters maxillary sinus
  • Advanced sinusitis can then spread the infection
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17
Q

What sinusitis can commonly spread to the eye? What sinusitis can commonly spread and cause meningitis, epidural abscesses?

A

Eye - ethmoid sinusitis

Meningitis, epidural abscesses - Frontal sinusitis

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18
Q

What is Allergic Fungal Sinusitis and what is a common organism that causes it?

A

Hypersensitivity to fungal organisms that colonize the sinus tract
– Ex. Aspergillus

19
Q

Histologic findings with Allergic Fungal Sinusitis?

A

Allergic mucin and fungal hyphae

– +/- mycetoma (fungal ball)

20
Q

Histologic findings with Allergic Fungal Sinusitis?

A

Allergic mucin and fungal hyphae

– +/- mycetoma (fungal ball)

21
Q

In what patients does Acute Invasive (fungal) Sinusitis occur?

A

Diabetic or immunosuppressed

22
Q

What fungal organism can commonly cause Acute Invasive Sinusitis?

A

Zygomycosis

23
Q

What is the emergent treatment and why for Acute Invasive (fungal) Sinusitis?

A

IV antifungal therapy to prevent spread to the brain and/or sepsis

24
Q

When Granulomatosis Polyangiitis affects the nasal passages and sinuses, what occurs?

A

Ulceration
Necrosis
Septum perforation

25
What is the characteristic histologic finding with Granulomatosis Polyangiitis?
Necrobiotic (blue) necrosis
26
Necrobiotic (blue) necrosis is seen with ____ and what are the symptoms in the nasal passages and sinuses?
Granulomatosis Polyangiitis | = Ulceration, necrosis, septum perforation
27
What are 2 benign tumors of the nose, sinuses and nasopharynx?
1. Nasopharyngeal Angiofibroma | 2. Sinonasal (schneiderian) Papilloma
28
What are 2 benign tumors of the nose, sinuses and nasopharynx?
1. Nasopharyngeal Angiofibroma | 2. Sinonasal (Schneiderian) Papilloma
29
Nasopharyngeal Angiofibroma - what is it, who is it seen in and what is its association?
- Polypoid mass (benign) - Seen in young men -- Associated with FAP (familial adenomatous polyposis)
30
Histologic appearance of a Nasopharyngeal Angiofibroma?
Vascular fibrous core
31
What benign tumor of the nose/sinus/nasopharynx is associated with FAP and what mutation/finding is involved with FAP?
Nasopharyngeal Angiofibroma - APC gene mutation = Colon polyps and carcinoma at a young age
32
Sinonasal (Schneiderian) Papilloma - who is it usually found in and what is its association?
- Middle aged men | - Associated with HPV infection
33
What are the 3 types of Schneiderian Papillomas and which one has the highest rate of recurrence/malignant transformation?
- Exophytic growth - Endophytic growth -- highest rate of recurrence - Oncocytic cells
34
What are 2 malignant tumors of the nose, sinuses, nasopharynx?
1. Olfactory Neuroblastoma | 2. Nasopharyngeal Carcinoma
35
What are 2 malignant tumors of the nose, sinuses, nasopharynx?
1. Olfactory Neuroblastoma | 2. Nasopharyngeal Carcinoma
36
An Olfactory Neuroblastoma is a malignant neuroendocrine tumor. What are its age peaks and what does it arise from?
Age peaks = adolescence and middle age | - Arises from neuroectoderm in the superior nasal passage
37
Histologic description of an Olfactory Neuroblastoma and what does it look like if it penetrates the cribriform plate?
Small round blue cell tumor | -- Dumb-bell shaped tumor when it penetrates cribriform plate
38
Small round blue cell malignant tumor that can be dumb-bell shaped
Olfactory Neuroblastoma
39
What malignant tumor arises from neuroectoderm in the superior nasal passage?
Olfactory Neuroblastoma
40
What malignant tumor is EBV related?
Nasopharyngeal Carcinoma
41
Where do a majority of Nasopharyngeal Carcinomas present and why?
In the neck due to lymph node metastasis
42
What type of carcinoma is Nasopharyngeal Carcinoma and what are the types?
Squamous - Keratinizing - Non-keratinizing - Basophilic with lymphoid tissue
43
In what 2 patient populations are Nasopharyngeal Carcinomas seen?
- Young African children = EBV | - Chinese/Asian adults = Smoked fish with nitrosamines or EBV

2 - CPR (pulmonary) (26 decks)

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