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Flashcards in 64 Diseases of head + neck Deck (26)
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1
Q

What is the most common malignant tumour of the oral cavity and larynx?

A

Squamous cell carcinoma.

2
Q

What is the long term survival for squamous cell carcinoma in the oral cavity?

A

50%

3
Q

Where do squamous cell carcinomas of the mouth commonly arise? (6)

A
Floor.
Ventrolateral tongue.
Retromolar region.
Lower lip.
Soft palate.
Gingiva.
4
Q

How does squamous cell carcinoma of the oral cavity commonly present? (4)

A

Pain.
Difficulty swallowing/speaking.
Numbness/tingling of the tongue.
White/dark patches.

5
Q

What is the aetiology of carcinoma of the oral cavity? (6)

A

Tobacco + alcohol (synergistic).
Smokeless tobacco containing areca nut + calcium hydroxide.
HPV.
Meat + red chilli powder.

6
Q

What are the important genetic changes that occur in carcinoma of the oral cavity? (3)

A

Inactivation of p16 + p53.

Over activation of cyclin-D (increased cell motility).

7
Q

Which conditions/lesions are precancerous to oral carcinoma? (6)

A
Submucous fibrosis.
Actinic keratosis.
Lichen planus.
Leukoplakia and erythroplakia.
Chronic hyperplastic candidosis.
8
Q

What is the aetiology of carcinoma of the larynx? (9)

A
Tobacco.
Alcohol.
HPV 6 + 11.
Dietary: Salt, preserved meats, dietary fats.
Metal/plastic workers.
Work: exposure to paint, diesel and gasoline fumes, asbestos.
Exposure to radiation.
Laryngopharyngeal reflux.
Genetic.
9
Q

Where do most carcinomas of the larynx arise?

A

On the true vocal cords.

10
Q

What are the symptoms of carcinoma of the larynx? (4)

A

Hoarseness.
Pain.
Haemoptysis.
Dysphagia.

11
Q

Lesions in Lichen planus? (3,2)
Pathogenesis?
Who?

A

Cutaneous: itchy, purple papules + Wickham’s striae.
Oral: reticular striations, ulcerative lesions.
T cell autoimmune.
Middle aged females.

12
Q

What are vocal cord nodules/polyps?
Who are they seen in? (3)
Symptoms?

A

Benign reactive lesions.
Heavy smokers/singers. Adult men.
Hoarseness and increasing effort.

13
Q

What is the aetiology of nasal polyps?
Effects?
Histology? (3)

A

Recurrent rhinitis leading to mucosal folds.
Large/multiple may stop sinus drainage - sinusitis.
Oedematous mucosa, hyperplastic mucous glands, eosinophil infiltrate.

14
Q

What is the aetiology of sinusitis? (2)

Which are most affected? (2)

A

Acute/ chronic rhinitis or extension of upper tooth infection through antrum.
Frontal, anterior ethmoid.

15
Q

Which bacteria are found in sinusitis?

A

Mixed oral.

Fungal if severe: mucomycosis in diabetics.

16
Q

What is a cholesteatoma?

Associated with?

A

Cystic lesions filled with cholesterol. May precipitate foreign body giant cell reaction.
Chronic otitis media.

17
Q

What is otosclerosis?
Pathogenesis?
Results in?

A

Bilateral abnormal bone deposition in middle ear. Familial.
Fibrous ankylosis - bony overgrowth - anchorage of middle ear bones to oval window.
Marked hearing loss.

18
Q

What is labyrinthitis?
Symptoms?
Causes? (4)

A

Inflammatory disorder of the inner ear.
Disturbed balance + hearing.
Bacterial, viral, Wegner’s granulomatosis, poyarteritis nodosa.

19
Q

What is Ramsay Hunt syndrome?

A

VZV in sensory ear nerves causing labrynthitis and facial paralysis.

20
Q

Which cancers affect the external ear?
Associated with?
Who?

A

Basal cell and squamous cell carcinomas.
Actinic radiation (sun).
Elderly men.

21
Q

In the ear canal, which cancer is most commonly seen?

In who?

A

Squamous cell carcinoma.

Women.

22
Q

What is a paraganglioma?
Symptoms? (5)
Who?
Behaviour?

A

Middle ear tumour.
Pulsatile tinnitus, hearing loss, aural pressure, pain, bloody otorrhea (discharge).
Middle aged women.
Very locally aggressive.

23
Q

What are the causative organisms in acute otitis media? (3)

A

Streptococcus pneumoniae
H. influenzae
Moraxella catarrhalis

24
Q

What is serous otitis media?

A

Eustachian tube obstruction results in serous fluid build up in middle ear.

25
Q

When does chronic otitis media occur?

Organisms? (3)

A

Persistent acute infection.

Pseudomonas aeruginosa, Staphylococcus aureus, fungal.

26
Q

What are the complications of chronic otitis media? (4)

A

Tympanic perforation + discharge
Aural polyps
Cholesteatoma
Disarticulation of ossicles - hearing loss.

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