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ENT SM > Pathology > Flashcards

Pathology Flashcards

1
Q

What type of cells line the auditory meatus and external canal

A

Epidermis (squamous epithelial cells)

This contains sebaceous and ceruminous glands

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2
Q

What type of cells line the middle ear

A

Columnar lined mucosa - contains ossicles

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3
Q

What is the function of the organ of corti ?

A

It contains the hair cells that give rise to nerve signals in response to sound vibrations.

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4
Q

What essentially is Schneiderian epithelium

A

Pseudo stratified columnar epithelium with goblet cells -> respiratory epithelium

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5
Q

What type of cells are found in the throat

A

Respiratory and squamous epithelium depending on anatomical site

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6
Q

What are the cells of the vocal cord

A

Squamous epithelium. Everything below is respiratory

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7
Q

What type of gland is the salivary gland

A

Exocrine

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8
Q

What is the biggest salivary gland

A

Parotid

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9
Q

What are the components of a salivary gland

A

Acinar component and ductular component

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10
Q

What is otitis Media

A

inflammation of the middle ear

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11
Q

What usually causes otitis media

A

Viral infection - occasionally bacterial Strep Pneumoniae, h influenzae

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12
Q

Who is most likely to develop otitis media

A

Children

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13
Q

What is a cholesteatoma

A

Not a tumour and doesn’t contain cholesterol!

It is abnormally situated squamous epithelium. High cell turnover and abundant keratin production

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14
Q

Who can develop a cholesteatoma

A

Any age group

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15
Q

What is a Vestibular Schwannoma

A

Benign tumour of Schwann Cells

Associated with vestibular portion of vestibulocochlear nerve (VIII)

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16
Q

Where do vestibular Schwannomas occur

A

Within the temporal bone

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17
Q

Describe the histological appearance of a Vestibular Schwannoma

A

Pretty
Lots of spindle cells
Haphazard cells and occasionally the nuclei line up which causes a linear appearance

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18
Q

Why is there no mitosis, necrosis etc. in a vestibular schwannoma

A

It is a benign tumour

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19
Q

What should be considered if a child presents with a bilateral vestibular schwannoma

A

Neurofibromatosis type 2

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20
Q

What are some features of Neurofibromatosis type 1

A

Widespread neurofibromas - bony defects, cafe au lat spots, axillary freckling and Lisch nodules

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21
Q

Where on the body are Lisch nodules found

A

In the eye

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22
Q

What is more common, NF1 or NF2

A

NF1

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23
Q

Who is mostly likely to develop a nasal polyp

A

Adults

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24
Q

What are the aetiologies for nasal polyps

A 
Allergy
infection
asthma
aspirin sensitivity 
nick exposure
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25
Q

What should be considered if a young patient presents with nasal polyps

A

Cystic Fibrosis

26
Q

What can often be seen histologically with nasal polyps

A

Inflammatory cells - mast and eosinophils

27
Q

What is a good diagnosis sign of a nasal polyp

A

Pain free even on prodding around

28
Q

What are some causes of rhinitis and sinusitis

A

Infectious

allergic - IgE mediated type 1 hypersensitivity

29
Q

What is Wegener’s granulomatosis

A

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

30
Q

What sort of people are likely to get a Wegener’s granulomatosis

A

Very rare but usually white patients >40 years old

31
Q

How do Wegener’s granulomatosis usually present

A

Pulmonary, renal disease or nasal symptoms of congestion, septal perforation

32
Q

If a patient presented with a nasal polyp and renal failure, what test would need to be done?

A

ANCA test

positive cANCA is Wegener’s

33
Q

What are the most common malignant lesions in ENT

A

squamous cell carcinoma

34
Q

Who is most likely to develop a nasopharyngeal carcinoma

A

Low incidence in UK but very high in the far east especially in males

35
Q

What do nasopharyngeal carcinomas have a strong association with

A

Epstein Barr virus

36
Q

What type of virus is more likely to cause carcinoma

A

HPV

37
Q

What type of virus is more likely to cause lymphoma

A

EBV

38
Q

What does EBV target

A

T cells and tells them to proliferate

39
Q

What does LMP-1 do

A

encodes other proteins that activate cyclins

40
Q

Where are laryngeal polyps found

A

middle 1/3 to posterior 1/3 on vocal cord.

41
Q

What is an ulcer

A

A break in the endothelium below the basement membrane

42
Q

What is a squamous papilloma often associated with

A

HPV exposure - types 6 and 11

43
Q

When are the 2 peaks of incidence of squamous papillomas

A
44
Q

What are paragangliomas

A

tumours arising in clusters of neuroendocrine cells dispersed throughout the body

45
Q

Where is a phaeochromocytoma found

A

adrenal medulla of the kidney

It is chromaffin positive

46
Q

Why might a paraganglioma occur

A

As part of MEN 2 (multiple endocrine neoplasia 2)

47
Q

What are the 2 main risk factors for a squamous cell carcinoma

A

Smoking and alcohol

48
Q

Describe the link between HPV and squamous cell carcinoma

A

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

49
Q

How do we stage squamous cell carcinomas

A

TNM staging

50
Q

Where is the most common site for almost all salivary tumours

A

Parotid gland

51
Q

True or false.

Tumours in smaller glands are more likely to be malignant

A

True

They also cause pain = red flag

52
Q

What is the most common type of tumour in the salivary glands

A

Pleomorphic adenoma

53
Q

Who is most likely to develop a pleomorphic adenoma

A

Females over 60

54
Q

What are some of the difficulties with pleomorphic adenomas

A

Lots of different shapes and sizes
Difficult to excise as they have a very jelly like material that can ooze out
High recurrence rate

55
Q

What is a Warthin’s Tumour

A

Second most common benign tumour that are rare outwith the parotid gland

56
Q

What are Warthin’s tumours associated with

A

smoking

57
Q

What is the most common malignant tumour in the palate worldwide

A

Mucoepidermoid carcinoma

In the UK it is an adenoid cystic carcinoma

58
Q

Who is most likely to develop an adenoid cystic tumour

A

Usually over 40 years

59
Q

What is the survival rate for adenoid cystic tumours

A

35% 5 year survival and tends to kill you slowly

60
Q

What is one of the difficulties with an adenoid cystic tumour

A

Can miss the tumour growing along the nerves

ENT SM (19 decks)

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