Upper respiratory tract pathology

Question 1

What is the majority of histology of the URT?

Answer 1

Pseudostratified ciliated columnar with interspersed goblet cells

Question 2

What is Kartagener’s syndrome?

Answer 2

Primary ciliary dymotility alongisde complete situs invertus

Question 3

What is the inheritance pattern of Kartagener’s syndrome?

Answer 3

Autosomal recessive

Question 4

What are the symptoms of primary ciliary dysmotility?

Answer 4

Reduced or absent mucus clearance from the lungs and subsequent susceptibility to recurrent respiratory infections. Many males will develop diminished or absent fertility and many individuals will do on to develop hearing loss and symptoms of otitis media

Question 5

What are the histopathological findings in chronic rhinitis?

Answer 5

Atrophy of mucous glands and surface epithelium, squamous metaplasia, fibrosis

Question 6

What are the histopathological findings of sinusitis?

Answer 6

Nasal and naso-sinal polyps

Question 7

What is the most common causative agent of pharyngitis?

Answer 7

Streptococcus pyogenes

Question 8

What are some of the severe effects of pharyngitis?

Answer 8

Tonsillitis, retropharyngeal abscess, peritonsillar abscess, cervical adenitis, parapharyngeal abscess, Ludwig’s angina

Question 9

What is Ludwig’s angina?

Answer 9

Ludwig’s angina is a rare skin infection that occurs on the floor of the mouth, underneath the tongue. This bacterial infection often occurs after a tooth abscess, which is a collection of pus in the center of a tooth. It can also follow other mouth infections or injuries.

Question 10

What is the cardinal triad of granulomatosis with polyangiitis?

Answer 10

1) Giant cell transformation
2) Arteritis/phlebitis
3) Zonal necrosis with karyorrhesis/leukocytoclasis

Question 11

What is granulomatosis with polyangiitis?

Answer 11

Granulomatosis with polyangiitis (GPA, previously known as Wegener’s granulomatosis) is a systemic vasculitis that affects both small and medium-sized vessels. Patients typically initially suffer from a limited form that may consist of constitutional symptoms and localized manifestations such as chronic sinusitis, rhinitis, otitis media, ocular conditions, and/or skin lesions. In later stages, more serious manifestations may arise, including pulmonary complications and glomerulonephritis, although the skin, eyes, and heart may also be involved.

Question 12

How is a diagnosis of GPA made?

Answer 12

Diagnosis is based on laboratory testing (positive for PR3-ANCA/c-ANCA), imaging, and biopsy of affected organs, which demonstrate necrotizing granulomatous inflammation.

Question 13

How is GPA managed?

Answer 13

GPA is treated with immunosuppressive drugs, typically consisting of glucocorticoids combined with methotrexate, cyclophosphamide, or rituximab. Relapses are common.

Question 14

Are the kidneys often affected?

Answer 14

Yes, 75% of GPA sufferers will experience kidney issues

Question 15

What is the peak age of incidence?

Answer 15

Middle age

Question 16

What is the primary race affected?

Answer 16

80-90% of sufferers are Caucasian

Question 17

What is Samter’s triad of inverted sinonasal papilloma?

Answer 17

Nasal polyposis, asthma, aspirin hypersensitivity

Question 18

What is inverted sinonasal papilloma? Are men or women more likely to be affected?

Answer 18

Unilateral nasal polyp. Men (5:1)

Question 19

What is the most common tumour of the URT?

Answer 19

Squamous cell carcinoma make up 95% of URT tumours

Question 20

What are the signs and symptoms of squamous cell carcinoma of the URT?

Answer 20

Blocked nose/sinuses.
Pain behind nose or upper teeth.
Epistaxis
Diplopia
Swelling around the eyes
Headache
Numbness

Question 21

In what group of people should adenocarcinoma of the URT be suspected?

Answer 21

Wood workers, furniture makers, chromate exposure

Question 22

Who in particular is affected by juvenile angiofibroma?

Answer 22

Pre-pubertal and adolescent males. It is testosterone related

Question 23

In terms of anatomy where does juvenile angiofibroma originate?

Answer 23

Originates in close proximity to the posterior attachment of the middle turbinate, near the superior border of the sphenopalatine foramen.

Question 24

What does UNCT stand for?

Answer 24

Undifferentiated carcinoma of nasopharyngeal type

Question 25

What virus is UNCT related to?

Answer 25

Epstein Barr virus

Question 26

What is the peak age of incidence of UNCT? Are men or women more affected?

Answer 26

50-60. Men (2:1)

Question 27

What are the signs and symptoms of UNCT?

Answer 27

Blocked nose, deafness, telecanthus, tinnitus, epistaxis, lymphadenopathy

Question 28

Why does UNCT cause deafness?

Answer 28

Blockage of the eustachian tube

Question 29

Is diphtheria gram positive of negative?

Answer 29

Gram positive

Question 30

What are the histopathological signs of diphtheria infection?

Answer 30

A pseudomembrane covering the tonsils which is a coagulum of dead cells, fibrin, inflammatory cells and bacteria

Question 31

What are the histopathological findings of tuberculosis?

Answer 31

Caseation necrosis and granulomatosis

Question 32

Why do some people develop vocal cord polyps/nodules?

Answer 32

Vocal cord abuse/ smoking. Results in very poor drainage and tense elastic cricoid cartilage results in painful swelling.