Upper respiratory tract pathology Flashcards
What are the main defence mechanisms in the upper respiratory tract?
Mucociliary transport system
Cough reflex
MALT (Waldeyer’s ring)
White blood cells and IgA secretion
What do the terms acute and atopic rhinitis mean
Acute rhinitis is a common cold
Atopic rhinitis is hay fever
What is the result to the tissues of acute rhinitis becoming chronic?
There can be atrophy of the mucous glands and surface epithelium. This leads to fibrosis and squamous metaplasia
What is sinusitis?
Similar to rhinitis but can originate from maxiallary antrum. It can lead to mucocoele and empyema.
In chronic state it can cause polyps to form in the nose and sinuses. These are masses of connective tissue infiltrated by inflammatory cells
What is pharyngitis, what is its cause?
mainly caused by S. Aureus and H. Influenzae infections. Can cause tonsilitis and abcesses
What is diptheria?
Gram positive baccilus that infects the upper airways and can create a pseudomembrane of dead cells over the pharynx and occasionally lower structures.
Commonly caured with antibiotics/ antitoxin
TB can commonly involve the larynx and be mistaken for carcinoma, what investigations and treatment are required for tb?
Investigations involve CXR and sputum culture
Treatment is through an antibiotic regime
What is granulatosis with polyangitiis? How is it diagnosed and treated?
Autoimmune multisystem disease that can affect the nose and paranasal sinuses
Causes inflammation of small and medium vessels.
Diagnosed with looking at anti neutrophil antibodies, cxr may show fluffy infiltrates from haemorrhage, urinanalysis may show proteinuria
It is treated with steroids and cyclophosphamide (immunosuppresant)
Also methotraxate and azathioprine
What is an inverted papilloma and what are the differentials? How is it treated?
it is a highy common benign tumour of the nose and paranasal sinuses.
Differentials are polyps and carcinoma
It is treated through surgery but must be monitored as high risk of recurrence
What is a juvenile angiofibroma and how is it treated?
This is a benign tumour that can develop in the upper respiratory tract.
It has androgen receptors on it so can just be treated with hormones. Increasing testosterone levels are curative
What are the common symptoms of a squamous cell carcinoma?
Patients will complain of blocked nose, pain, numbness and swelling. Diagnosis is made through imaging and biopsy.
How is squamous cell carcinoma treated?
Depends on stage but can be through surgery, radiotherapy and occasionally chemotherapy
What are the signs and symptoms of nasopharangeal carcinoma? What is the treatment?
More common in asia, thought to be linked to dietary nitrosamines
Common symptoms are pain, epitaxis (nose bleed), blocked nose, deafness and tinnitus
Treatment usually radiotherapy and surgical removal of lymph nodes
What is the most common salivary gland lesion?
Mumps
Typically affects parotid glands bilaterally
What is acute supperative parotitis?
pyogenic infection of the parotid gland, often post operatively
