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CPR 2 Pulm Section > Respiratory Pathology Pt. 6 > Flashcards

Respiratory Pathology Pt. 6 Flashcards

1
Q

What are viral causes of infectious rhinitis/sinusitis?

A
  • rhinovirus
  • coronavirus
  • adenovirus
  • echovirus
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2
Q

What are bacterial causes of infectious rhinitis/sinusitis?

A
  • Strep pneumo

- Haemophilus influenzae

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3
Q

What do the nasal secretions look like in viral rhinitis/sinusitis vs. bacterial?

A

viral: clear
bacterial: thick, purulent

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4
Q

What causes inflammatory sinonasal polyps?

A

chronic rhinitis/sinusitis

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5
Q

What would you see on histology of inflammatory sinonasal polyps?

A
  • edema in the stroma

- eosinophilic infiltrate

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6
Q

To what sinus cavity would a tooth infxn spread?

A

maxillary

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7
Q

What sinus cavity is most likely to have complications such as orbital cellulitis and orbital abscess?

A

ethmoid

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8
Q

What sinus cavity is most likely to have complications such as meningitis and brain abscess?

A

frontal

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9
Q

What would be seen on histology of allergic fungal sinusitis?

A
  • allergic mucin
  • Charcot Leyden crystals
  • eosinophils
  • fungal hyphae
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10
Q

What is a mycetoma?

A
  • “fungal ball”

- possibly seen in fungal sinusitis

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11
Q

What population of patients is most at-risk for the acute invasive sinusitis form of fungal sinusitis?

A

diabetics or immunocompromised

often Mucor

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12
Q

What are possible complications of acute invasive sinusitis d/t fungal sinusitis and what is the Tx?

A
  • infxn spread to brain
  • sepsis

-emergent situation requiring IV antifungal therapy

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13
Q

What age is typical for onset of Granulomatosis w/ Polyangiitis?

A

middle-aged adults

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14
Q

How does Granulomatosis w/ Polyangiitis affect the nasal passages and sinuses?

A
  • ulceration
  • necrosis
  • perforated septum
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15
Q

What will you seen on histology of Granulomatosis w/ Polyangiitis?

A
  • granulomatous inflammation/vasculitis

- “necrobiotic” necrosis (blue)

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16
Q

What are two benign tumors of the nose/sinus/nasopharynx?

A
  • nasopharyngeal angiofibroma

- sinonasal (Schneiderian) papilloma

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17
Q

What are some malignant tumors of the nose/sinus/nasopharynx?

A
  • olfactory neuroblastoma
  • NUT (Nuclear Protein of the Testis) midline carcinoma
  • EBV malignancies (ex: nasopharyngeal carcinoma, extranodal NK/T cell lymphoma)
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18
Q

What is the typical patient population for nasopharyngeal angiofibroma?

A

-young men

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19
Q

What is seen on histology of nasopharyngeal angiofibroma?

A
  • vascular fibrous core lined by benign epithelium
  • spindle cell proliferation
  • looks exactly like penile erectile tissue
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20
Q

What genetic condition is associated with nasopharyngeal angiofibromas?

A

-Familial Adenomatous Polyposis (FAP), which is caused by a mutation in the APC gene

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21
Q

True or False: after removal, nasopharyngeal angiofibromas can recur

A

True.

they also bleed b/c of high vascularity

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22
Q

What population demographic is typical for Sinonasal (Schneiderian) Papilloma?

A

–middle-aged men (more-so than women)

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23
Q

What two patterns of growth could a Sinonasal (Schneiderian) Papilloma exhibit?

A
  • exophytic

- endophytic

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24
Q

What are the characteristics of an endophytic Sinonasal (Schneiderian) Papilloma?

A
  • high rate of recurrence
  • may progress to malignancy (10%)
  • difficult to resect
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25
What is seen on histology of an Olfactory Neuroblastoma?
- "small round blue cell tumor" | - rosettes
26
From what type of tissue does an Olfactory Neuroblastoma arise?
neuroectoderm | it's a neuroendocrine tumor
27
True or False: olfactory neuroblastomas have a bimodal age distribution
- adolescence | - middle age
28
In what shape does an olfactory neuroblastoma grow and why?
"dumb-bell" tumor because it runs out of room growing downward, so then it penetrates the cribriform plate and grows upward
29
What type of cancer is nasopharyngeal carcinoma?
squamous cell carcinoma - keratinizing (or non-keratinizing) - basophilic w/ lymphoid tissue
30
Where do the majority of cases of nasopharyngeal carcinoma present?
-in the neck d/t lymph node metastasis
31
What virus is a risk factor for nasopharyngeal carcinoma?
EBV | especially in young African children; this type has a better prognosis
32
What subset of adults has an increased risk of nasopharyngeal carcinoma and why?
Chinese and Southeast Asians d/t ingestion of smoked fish w/nitrosamines (also EBV-related)
33
What virus is a risk factor for Extranodal NK/T cell lymphoma?
EBV
34
What demographic has a higher incidence of Extranodal NK/T cell lymphoma?
- occurs at any age, but peaks in middle age | - higher incidence in Asia and Latin America
35
What effects does Extranodal NK/T cell lymphoma have on the sinuses?
-necrotic destruction of the paranasal sinuses (necrosis occurs b/c these tumors are so aggressive)
36
What are systemic symptoms of lymphoma?
- fever - night sweats - weight loss
37
What are vocal cord nodules (aka "singer's nodules")?
- reactive process (not infxn, not dysplastic or neoplastic) | - an expansion of the soft tissue underlying the vocal fold in Rienke's space)
38
What do vocal cord nodules look like on gross appearance?
- soft | - translucent
39
What do vocal cord nodules look like on histology?
- edema | - loose stroma underlying benign squamous epithelium
40
Are laryngeal squamous papillomas a neoplasm?
Yes, benign w/ a papillary appearance.
41
With what virus are laryngeal squamous papillomas associated?
HPV 6 and 11
42
What do laryngeal squamous papillomas look like on gross appearance?
friable papillary masses
43
What do laryngeal squamous papillomas look like on histology?
benign or mildly atypical squamous epithelium w/ multiple papillae
44
What condition is associated with multiple laryngeal squamous papillomas?
recurrent respiratory papillomatosis
45
What age demographic is most typical for recurrent respiratory papillomatosis?
-children and adolescents
46
With what virus is recurrent respiratory papillomatosis associated?
HPV 6 and 11
47
What are risk factors of recurrent respiratory papillomatosis?
- -mothers < 20yrs old - -vaginal delivery - -first-born
48
How does recurrent respiratory papillomatosis affect the lungs?
--cysts throughout lungs that cause air-trapping
49
True or False: recurrent respiratory papillomatosis has a malignant progression
True, but only rarely. Less than 1% are malignant.
50
What type of cancer is laryngeal carcinoma?
squamous cell carcinoma
51
In what demographic is laryngeal carcinoma seen more commonly?
men > 60 yrs
52
What are risk factors for laryngeal carcinoma?
- smoking - alcohol - HPV infxn
53
What type of combined influence do smoking and alcohol have on laryngeal carcinoma?
synergistic
54
What causes most of the cases of otitis media: viruses or bacteria?
viruses
55
What bacteria are most commonly responsible for bacterial otitis media?
- Step pneumo - Moraxella catarrhalis - Haemophilus influenzae -Pseudomonas aeruginosa in diabetics
56
What is cholesteatoma?
- reactive process (not a neoplasm) - cystic lesion that arises d/t chronic otitis media - lined by benign squamous epithelium w/ trapped keratin debris
57
Why must a cholesteatoma be removed?
-can enlarge and erode adjacent bone
58
What is otosclerosis?
- abnormal bony deposition | - typically at the stapedial footplate
59
What complication does otosclerosis cause?
conductive hearing loss (d/t lack of vibration)
60
With what inheritance pattern might otosclerosis be connected?
autosomal dominant
61
What is the Tx for otosclerosis?
-stapes prosthesis
62
Where is the most common location of a branchial cyst?
anterior to the SCM
63
In what age group are branchial cysts most commonly diagnosed?
young adults
64
How do branchial cysts appear on histology?
simple cyst lined by stratified squamous or respiratory epithelium w/ surrounding fibrous tissue
65
What is the most common tumor of the neck in adults?
1) metastatic cystic carcinoma | 2) thyroglossal duct cyst
66
What is the most common tumor of the neck in adolescents and younger?
1) thyroglossal duct cyst | 2) branchial cleft cyst
67
What is a thyroglossal duct cyst?
remnant nest of tissue from thyroid migration, with cystic change
68
What will you see on histology of a thyroglossal duct cyst?
thyroid follicles filled w/ pink colloid
69
What is the cell origin of a carotid body tumor?
neural crest (arising from autonomic paraganglia)
70
With what syndrome might a carotid body tumor be associated?
MEN 2
71
What sign does a carotid body tumor produce on imaging?
Lyre Sign (splaying of the carotids)
72
What does a carotid body tumor look like on histology?
-nests of cells ("zellballen")
73
True or False: malignancy of carotid body tumors can be distinguished from histology
False

CPR 2 Pulm Section (9 decks)

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