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Clinical Pathology > Theme 11: Skin and Musculoskeletal Pathology > Flashcards

Theme 11: Skin and Musculoskeletal Pathology Flashcards

1
Q

What lesions are caused by vocal abuse?

A

Vocal cord nodules (bilateral)

Vocal cord polyps (unilateral)

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2
Q

Where do vocal cord polyps normally occur?

A

Reinke’s space/ventricular space, anterior half

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3
Q

Which group is more at risk of developing vocal cord polyps?

A

Young women, though can occur at any age

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4
Q

Professional singers are most at risk of developing this type of lesion.

A

Vocal cord nodules and polyps

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5
Q

How does the common aetiology of vocal cord nodules and polyps cause the changes in the stroma?

A

Trauma damages the tissues or triggers inflammatory response, leading to vascular permeability and oedema and eventually fibrosis.

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6
Q

“Polypoid lesions formed by expansion of the lamina propria by fluids, protein and fibrosis. Rhinorrhoea and chronic headaches are common clinical features”

A

Sinonasal polyps

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7
Q

Why do sinonasal polyps cause chronic headaches?

A

They can lead to obstruction of the outflowing sinuses, leading to increased pressure in the sinuses.

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8
Q

What are the causes of sinonasal polyps?

A

Allergy, infection, diabetes, aspirin sensitivity, asthma, cystic fibrosis

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9
Q

Do sinonasal polyps have potential for malignant transformation?

A

No

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10
Q

A condition associated with recurrent attacks of rhinitis, in which eosinophils are prominent

A

Nasal polyps

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11
Q

What causes allergic fungal sinusitis?

A

Hypersensitivity to fungal antigens

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12
Q

Is allergic fungal sinusitis more common in cooler or warmer climates?

A

Warmer

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13
Q

What are the clinical features of allergic fungal sinusitis?

A

Allergic symptoms, rhinorrhoea, headaches and obstruction

Peripheral eosinophilia, elevated IgG

Inspissated (thick) mucus with fungal hyphae (commonly aspergillus) and Charcot-Leyden crystals (eosinophil protein crystals)

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14
Q

What is the cause of oral lichen planus?

A

Aetiology is unknown

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15
Q

Which gender is more at risk of developing lichen planus?

A

Female > males

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16
Q

What feature is characteristic of reticular lichen planus?

A

Wickham Striae (fine, white, lace-like striae)

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17
Q

What feature is characteristic of erosive lichen planus?

A

Atrophic oedematous mucosa with ulcerations

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18
Q

Is lichen planus associated with increased malignant potential?

A

Yes

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19
Q

What is the most common malignancy of the oral cavity?

A

Squamous cell carcinoma

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20
Q

What are leukoplakia and erythroplakia often associated with?

A

Squamous cell carcinoma

SCC of the oral cavity is often preceded by white (leukoplakia) or red (erythroplakia) mucosal patches.

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21
Q

True or false: Squamous cell carcinoma of the oropharynx is associated with sexually transmitted infection

A

True.

SCC of the oropharynx is commonly associated with HPV 16 and 18. The variants associated with HPV have a better prognosis than those associated with smoking and alcohol

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22
Q

What are the most common sites for developing SCC of the oropharynx?

A

Tonsils and base of the tongue

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23
Q

What is the most common salivary gland neoplasm?

A

Pleomorphic adenoma

Benign neoplasm composed of ductal epithelial cells and myoepithelial cells within a mesenchymal stroma

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24
Q

Where are pleomorphic adenomas most commonly found?

A

Parotid gland

25
Q

Do pleomorphic adenomas have a significant malignant potential?

A

Yes, there is a ~1% risk of malignant transformation per year to form ‘carcinoma ex-pleomorphic adenoma’.

26
Q

What are the clinical symptoms associated with pleomorphic adenoma.

A

Asymptomatic, slow-growing mass

27
Q

“A basaloid malignancy of the salivary glands consisting of epithelial and myoepithelial cells. Most commonly arise in minor salivary glands.”

A

Adenoid cystic carcinoma

28
Q

True or false: Adenoid cystic carcinomas are incurable.

A

True

All patients will die with the tumour, and many will die because of it.

60% will metastasize to lung, bone, brain, liver

29
Q

Adenoid cystic carcinomas account for what % of salivary gland neoplasms?

A

10%

30
Q

What % of adenoid cystic carcinomas arise in minor salivary glands?

A

75%

31
Q

“Carcinoma arising in association with pleomorphic adenoma”

A

Carcinoma ex-pleomorphic adenoma

32
Q

What prognosis is associated with a carcinoma ex-pleomorphic adenoma that has invaded 1mm beyond it’s capsule?

A

Good.

Generally, if a carcinoma ex-pleomorphic adenoma has invaded <1.5mm beyond the capsule, the prognosis is good.

33
Q

What prognosis is associated with a carcinoma ex-pleomorphic adenoma that has invaded 2mm beyond the capsule?

A

Bad.

Generally, if a carcinoma ex-pleomorphic adenoma had invaded >1.5mm beyond the capsule, the prognosis is bad (<50% 5y survival)

34
Q

What is the most common benign neoplasm of the larynx?

A

Juvenile laryngeal papillomatosis

35
Q

What is the most common malignant neoplasm of the sinonasal tract?

A

Squamous cell carcinoma of the nose and paranasal sinuses

36
Q

What is the most common tumour encountered in the oral cavity?

A

Fibroepithelial polyp

37
Q

What is the most common malignancy of the oral cavity?

A

Squamous cell carcinoma

38
Q

What is the most common non-neoplastic lesion of the salivary glands?

A

Salivary gland mucocele

39
Q

What is the most common salivary gland neoplasm

A

Pleomorphic adenoma

40
Q

Warthin’s tumour is most common in which salivary gland?

A

Parotid

It is the 2nd most common parotid gland tumour

41
Q

What is the most common bilateral tumour?

A

Warthin’s tumour

42
Q

Joint disorder associated with hyperuricaemia

A

Gout

43
Q

Which skin condition commonly results in “butterfly rash” on the face?

A

Lupus erthematosus

44
Q

Condition with itchy plaques known as Wickham’s striae

A

Lichen planus

45
Q

A premalignant condition common in sun-exposed sites

A

Actinic keratosis

46
Q

Malignant tumour of bones

A

Osteosarcoma

47
Q

A condition with a ‘heliotropic rash’

A

Dermatomyositis

48
Q

Most common cancer of the oral cavity

A

Squamous cell carcinoma

49
Q

Inflammatory skin condition with well-defined plaques on the extensor surfaces

A

Psoriasis

50
Q

Most common malignancy of the skin

A

Basal cell carcinoma

51
Q

Treatment of choice for uncomplicated shingles

A

Aciclovir

52
Q

Fungal infection of the scalp

A

Tinea capitis

53
Q

A condition associated with recurrent attacks of rhinitis, in which eosinophils are prominent

A

Nasal polyps

54
Q

__?__ thickness is used as a prognostic parameter in melanoma

A

Breslow’s

55
Q

Atopic eczema is a type __?__ hypersensitivity reaction

A

1

56
Q

Contact dermatitis is a type __?__ hypersensitivity reaction

A

4 (delayed)

57
Q

What types of dermatitis are included under ‘dermatitis of unknown aetiology’?

A

Seborrhoeic dermatitis
- affect areas rich in sebaceous glands: scalp, forehead, upper chest

Nummular dermatitis
- oval- or coin-shaped lesions

58
Q

What is Auspitz sign?

A

Sign associated with psoriasis, in which removal of a scale causes small bleeding points

Clinical Pathology (11 decks)

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