Throat Pathology

Question 1

signs of foreign body aspiration?

what type of infection may occur soon after?

Answer 1

SOB + drooling as there is increase swelling + oedema at site

risk of pneumonia

Question 2

in reference to trauma, how it the head and neck split up into sections?

what is the most “at risk” area?

Answer 2

Zone 1-3
(face is zone 3)

zone 1 has worst mortality rates for stabbings etc

Question 3

you have stabilised the neck trauma patient using ABCDE. They are coughing up blood, have inequal chest expansion and you suspect a foreign body. what 3 imaging techniques could you maybe need?

Answer 3

CXR - foreign body, look at lungs, haemo-pneumothorax potential

CT angiogram for vascular issues too

Laryngoscope / another “scope”

Question 4

describe where a “deep neck space” infection spreads and how to manage it

Answer 4

from tonsils/ oropharynx (retropharyngeal danger space) down into the mediastum

serious = ABCDE fluid resus
IV antibiotics
incision and drainage

Question 5

what is stertor?

Answer 5

low pitched breathing sounds due to obstruction from lower

Question 6

you have stabilised a patient with airway obstruction using ABCDE. what next??

• two medical Tx options
• 1 type of endoscopy with Tx
• 2 types of surgical treatment

Answer 6

ABCDE = can use Heliox

medical

• steroids
• adrenaline

Endoscopy
- Flexible fibre-optic endoscopy under GA.

surgical

• cricothyroidectomy
• tracheostomy

Question 7

recurrent benign tumours in the aerodigestive tract

• name?
• infective cause?

Answer 7

Recurrent Respiratory Papillomatosis

caused by HPV virus (STI)

can be removed by keep recurring

juvenile or adult versions

Question 8

what is the name of the salivary gland infection that classically appears in old debilitated people with poor dentition, giving painful swelling + fever?

Answer 8

Sialeadenitis

• submandib
• parotid

Question 9

what is the name for calcium stones in the salivary glands?

• most common gland to get them?

Answer 9

Sialolithiasis

• submandib as thicker secretions
• pain + tense swelling with meals

Question 10

most common salivary gland tumour? (by far…)

Answer 10

64% of all SG tumours are benign pleomorphic adenomas in the parotid gland

Question 11

51 year old woman present with a right side of face swelling that she first noticed 18 months ago. no other symptoms. what is the likely Dx?

Answer 11

Pleomorphic adenoma of the parotid gland

women in 40-60s

slow growing

can become malignant = OUT

Question 12

tim (59) has 2 swellings on either preauricular side. he noticed 1 side 6 months before the other. he smokes 50 a day. no other symptoms. likely tumour?

Answer 12

WARTHINS tumour

2nd most common benign salivary gland (parotid) tumour

bilateral, multicentric

male + smoker + > 50

Question 13

what salivary gland is most likely to get malignant tumours?

2 important risk factors

• social
• PMHx

Answer 13

subMandibular = M for malignancy

smoking
previous radiation

Question 14

2 malignant salivary gland tumours

• # 1 worldwide
• # 1 UK, spreads slowly + perineurally

Answer 14

worldwide = mucoepidermoid tumour

UK = Adenoid cyst

both get excised + radiotherapy

Question 15

2 examples of non-cancerous pathology in the larynx?

Answer 15

1. polyps - mucosa change in response to a trigger

2. contact ulcers - response to injury eg. intubation or vocal abuse

Question 16

HPV is a risk factor for some laryngeal cancers.

name 1 x benign

name 1 x malignant

Answer 16

benign = squamous papilloma

malignant = laryngeal SCC