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ENT > Pathology > Flashcards

Pathology Flashcards

1
Q

What are the auditory and external canal lined with? and what glands does it contain?

A

Epidermis (skin)

Contains sebaceous and ceruminous glands

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2
Q

What is the middle ear lined with?

A

Columnar lined mucosa

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3
Q

Where are the ossicles?

A

Middle ear, petrous

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4
Q

What are the 3 ossicles?

A

Malleus, incus and stapes

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5
Q

What does the inner ear contain?

A

the cochlea and the vestibular apparatus

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6
Q

What is the nasal vestibule lined with?

A

Squamous cell epithelium

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7
Q

What is the nose, sunis etc lined with? What glands does it contain?

A

Schneiderian epithelium (same as resp mucosa e.g. pseudostratified ciliated columnar) Contains mucinous glands for producing snot

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8
Q

What is the throat lined with?

A

Respiratory and squamous epithelium depending on anatomical site

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9
Q

What kind of gland is the salivary gland?

A

Exocrine gland

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10
Q

What cells make up the salivary gland?

A

Serous cells - darkly staining. Contain digestive enzymes including amylase

Peripheral myoepithelium cells

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11
Q

What is Otitis Media?

A

Inflammation of the middle ear. Usually viral and occasionally bacteria.

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12
Q

What bacteria causes Otitis Media?

A

Strep. Pnuemoniae, H. Influenzae and Moxarella Catarrhalis. If chronic – Pseudomonas Aeruginosa

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13
Q

What is Cholestoma?

A

Squamous epithelium in the middle ear which has come from the outer ear, causing a mass. NOT A TUMOUR and doesn’t contain cholesterol. Common and can occur at any age

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14
Q

What are the classic signs of Choelstoma?

A

Cheesy, yellowy discharge which is kertain produced by the mass

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15
Q

Where does a Cholestoma appear?

A

Superior posterior middle ear and/or petrous apex

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16
Q

Pathogenesis of Cholestoma

A

Chronic otitis media and perforated tympanic membrane (acquired)

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17
Q

Vestibular Schwannoma

A

a benign, usually slow-growing tumor that develops from the balance and hearing nerves supplying the inner ear. Associated with vestibular portion of vestibulocochlear nerve (VII). Occur within temporal bone and represent 80-90% of cerebellopontine angle tumours

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18
Q

What is Vestibular Schwannoma composed of?

A

tumour of spindle schwann cells. Nuclei line up at the same point - nuclear palisading

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19
Q

What disease do you consider in the Vestibular Schwannoma is bilateral and patient is young?

A

NF type 2

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20
Q

Patient with widespread neurofibromas, bony defects, au lait spots, axillary freckling, Lisch nodules

A

NF 1 (auntosomal dominant)

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21
Q

Bilateral Vestibular Schwannoma, multiples meningomas, Gilomas, Cafe au lait

A

NF type 2

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22
Q

If someone has nasal polyps at a young age what disease might this be?

A

CF

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23
Q

What can cause nasal polyps?

A 
Allergy
infection
asthma
aspirin sensitivity
nickel exposure
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24
Q

What is a nasal polyp?

A

Fluid filled sacs of the normal mucosa in the nasal passge

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25
Q

Autoimmune disorder of unkown aetiology characterised by a small vessel vasculitis limited to respiratory tract and kidneys

A

Wegener’s Granulomatosis

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26
Q

What does Wegener’s Granulomatosis present with?

A

Present with pulmonary, renal disease or nasal symptoms of congestion, septal perforation etc. might present with renal failure, non healing ulcers of nasal septum

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27
Q

Who present with Wegener’s Granulomatosis

A

Rare. Usually white patients and >40years old.

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28
Q

pANCA antibody

A

microscopic polyangiitis

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29
Q

cANCA antibody

A

Wegener’s Granulomatosis

30
Q

What benign lesions appear up to the nose ?

A

squamous papillomas
“Schneiderian” papillomas
Angiofibromas

31
Q

What is the most common malignant tumour up the nose?

A

Squamous cell carcinoma

(also can get adenocarcinoma, nasopharyngeal carcinoma, neuroblastoma, lymphoma

32
Q

What nasal tumour has strong association with Epstein Barr virus as well as volatile nitrosamines in food?

A

Nasopharyngeal carcinoma

(Low incidence in UK. Very high in far east.
Males)

33
Q

What are laryngeal polyps?

A

Reactive change in laryngeal mucosa

34
Q

What causes laryngeal polyps?

A

vocal abuse, infection and smoking. Occ. in hypothyroidism.

35
Q

What causes contact ulcers in the throat?

A

Chronic throat, voice abuse, gastrooesophageal reflux (GORD)

36
Q

what is Squamous papilloma/papillomatosis?

A

A squamous cell papilloma is a generally benign papilloma that arises from the stratified squamous epithelium of the skin, lip, oral cavity, tongue, pharynx, larynx, esophagus, cervix, vagina or anal canal.

37
Q

What infection is associated Squamous papilloma/papillomatosis

A

HPV (types 6 and 11)

38
Q

how does Squamous papilloma/papillomatosis

present in children?

A

V aggressive disease (>5 yrs)

39
Q

How does Squamous papilloma/papillomatosis

present in adults?

A

often solitary and possibly not related to HPV 6 & 11. (20-40 yrs)

40
Q

What is paraglanglioma?

A

Tumours arrising in clusters of neuroendocrine cells dispersed throughout the body. Nested tumours

Chromaffin positive and also non-chromaffin

41
Q

What endocrine disease is associated with paraganglioma?

A

multiple endocrine neoplasia 2

42
Q

What infection is associated with Squamous cell carcinoma?

A

HPV (type 16)

43
Q

What are the major salivary glands?

A

Parotid
Submandibular
Sublingual
Minor salivary glands

44
Q

Most common benign tumour in the salivary gland?

A

Pleomorphic adenoma

45
Q

Why is Pleomorphic adenoma difficult to excise?

A

Not well capsulated, jelly like substance, no borders

46
Q

What is the second most common benign tumour of the salivary gland?

A

Warthin’s Tumour (mainly in partoid and often bilateral)

47
Q

What causes chronic otitis media ?

A

Pseudomonas Aeruginosa

48
Q

What are the 3 main ENT tumours?

A

Squmous papillpma
Schneiderian papillpmas
Angiofibromas

49
Q

What is the most common malignant tumour in ENT?

A

Squamous cell carcinoma

50
Q

Which primary ENT tumour is common in Asia and the far east ?

A

Nasopharyngeal carcinoma

51
Q

What virus is Nasopharyngeal carcinoma associated with ?

A

EBV

52
Q

What are laryngeal poylps?

A

Reactive change in laryngeal mucosa (secondary change)

53
Q

What causes laryngeal poylps?

A

vocal abuse, infection and smoking. Occ. in hypothyroidism.

54
Q

What is a contact ulcer and what causes it?

A

Benign response to injury in the epithelium (break beneath the basement membrane) and granulation tissue forms.

Causes: chronic throat, voice abuse, GORD

55
Q

What are the 2 peaks in age for squamous papilloma?

A
56
Q

In children what virus is associated with squamous papilloma?

A

HPV types 6 and 11 (no associated in adults)

57
Q

What are paraganglioma?

A

Tumours arrising in clusters of neuroendocrine cells dispersed throughout the body.

58
Q

What are the two types of paraganglioma?

A

Chromaffin positive and non-chromaffin

59
Q

Where do the chromaffine positive paraganglioma appear?

A

sympathetic nervous system and can secrete catecholamines. Usually adrenal medulla or paravertebral – organ of Zuckerkandl

60
Q

Where do the non-chromaffine paraganglioma appear?

A

carotid bodies, aortic bodies, jugulotympanic ganglia, ganglia nodosum of vagus and clusters around oral cavity, nose, nasopharynx, larynx and orbit.

61
Q

What age does paraganglioma arise?

A

Can arise at any age but usually >50

62
Q

What endorcine disease is paraganglioma associated with?

A

Can occur as part of multiple endocrine neoplasia 2.

63
Q

What virus is squamous cell carcinoma associated with?

A

HPV type 16 (largely in oropharynx)

64
Q

What does HPV type 16 do ?

A

Produces proteins E6 and E7 which disrupt p53 and RB pathways respectively, leading to cellular immortality

65
Q

What is sialolthiasis?

A

Salivary gland stones

66
Q

What disease does paramyxovirus cause?

A

Mumps
Bilateral parotisis
Associated orchitis
Risk of secondary meningitis

67
Q

What is the most common benign salivary gland tumour?

A

Pleomorphic adenoma

68
Q

Most common presentation for pleomorphic adenoma?

A

Female, >60 in parotid with long history

69
Q

What is the second most common benign tumour the salivary glands?

A

Warthin’s tumour

70
Q

What is the most common malignant tumour in the world for the salivary glands?

A

Mucoepidermoid carcinoma

71
Q

What is the most common malignant tumour in the UK for the salivary glands?

A

Adenoid cystic carcinoma

72
Q

What is the most common malignant tumour of the palate and has frequent perineural invasion?

A

Adenoid cystic carcinoma

ENT (8 decks)

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