Ch 16

Question 1

What are the most common organisms causing rhinitis?

Answer 1

Adenovirus
Rhinovirus
Echovirus

Question 2

What are the major nasal findings in rhinitis?

Answer 2

Thickened, edematous, red nasal mucosa

Enlarged turbinates

Question 3

What separates allergic rhinitis from infectious rhinitis?

Answer 3

Presence of eosinophilia

Question 4

Recurrent attacks of rhinitis can cause ___?

Answer 4

Nasal polyps

Question 5

Histology = edematous mucosa with loose stroma containing hyperplastic/cystic mucosal glands

Answer 5

Nasal polyp

Question 6

If a child has a nasal polyp, what congenital disease should you think of?

Answer 6

Cystic Fibrosis

Question 7

Histology = superficial desquamation/ulceration of mucosal epithelium with abundance of neutrophils

Answer 7

Chronic rhinitis

Question 8

What are the most common offending agents of sinusitis?

Answer 8

Inhabitants of the oral cavity

Question 9

What pathology is caused by impaired drainage of a sinus by inflammation?

Answer 9

Sinusitis

Question 10

If the blockage of a sinus is complete, not allowing the exudate to escape, what can form?

Answer 10

Empyema

Question 11

Chronic sinusitis associate with DM is most often caused by what organism?

Answer 11

Mucormycosis

Question 12

Which organisms are most likely to cause necrotizing lesions of the nose and upper airway?

Answer 12

Candida, Mucor, Aspergillus

Question 13

What type of pts are most at risk for necrotizing lesions of the nose and upper airway?

Answer 13

Immunosupressed with DM

Question 14

What disease is associated with a presentation of non-healing ulcers around the nasopharynx?

Answer 14

Granulomatosis with Polyangiitis

Question 15

Which Ab is found in Granulomatosis with Polyangiitis?

Answer 15

PR3-ANCA

Question 16

What is the triad of Sx’s for Granulomatosis with Polyangiitis?

Answer 16

Necrotizing granulomas of URT/LRT, vessels, and glomerulus

Question 17

What are the most common organisms to cause pharyngitis or laryngitis?

Answer 17

Adenovirus, Rhinovirus, Echovirus

Question 18

Sx’s = reddening/edema of nasopharyngeal mucosa with enlargement of tonsils and LN’s

Answer 18

Pharyngitis/Laryngitis

Question 19

If a bacterial infection is superimposed on pharyngitis/laryngitis, what are the most common type?

Answer 19

ß-hemolytic strep

S. Aureus

Question 20

Benign, vascular tumor seen in adolescent males with fair skin and red hair

Answer 20

Nasopharyngeal Angiofibroma

Question 21

What cancer is associated with FAP?

Answer 21

Nasopharyngeal Angiofibroma

Question 22

Where do Nasopharyngeal Angiofibromas arise?

Answer 22

Roof of nasal cavity

Question 23

Benign tumor from respiratory mucosa lining the nasal cavity and paranasal sinuses

Answer 23

Sinonasal Papilloma

Question 24

Which type of Sinonasal Papilloma is most aggressive and arises in men 30-60 yo

Answer 24

Endophytic/Inverted

Question 25

What is a potential complication of Sinonasal Papilloma's?

Answer 25

Invasion into the orbit or cranial vault

Question 26

Tumor arising from neuroectodermal olfactory cells in the superior aspect of the nasal cavity

Answer 26

Olfactory Neuroblastoma

Question 27

Pts present with nasal obstruction and epistaxis around 15 or 50 yo

Answer 27

Olfactory Neuroblastoma

Question 28

Histology = small, blue, round cell neoplasms made of nests/lobules of well-circumscribed cells separated by fibrovascular stroma

Answer 28

Olfactory Neuroblastoma

Question 29

Olfactory Neuroblastomas will stain + for ___?

Answer 29

Chromogranin, Synaptophysin, CD56

Question 30

Tumor that may occur in nasopharynx, salivary glands, or other midline structures due to creation of BRD4-NUT fusion gene

Answer 30

NUT Midline Carcinoma

Question 31

Tumor associated with lymphoid tissue or EBV with nasal obstruction, epistaxis, metastases to cervical LNs

Answer 31

Nasopharyngeal Carcinoma

Question 32

In what populations are Nasopharyngeal Carcinomas most common?

Answer 32

``` Africa = children China = adults ```

Question 33

Histology = epithelial cells with oval/round nuclei and indistinct cell borders creating syncytium-like array

Answer 33

Nasopharyngeal Carcinoma

Question 34

EBER-1 and LMP-1 detected

Answer 34

Nasopharyngeal Carcinoma

Question 35

What are the most common organisms responsible for laryngeal inflammation in children?

Answer 35

RSV, H. Influenzae, ß-hemolytic strep

Question 36

Where do vocal cord nodules appear?

Answer 36

Singers nodules = bilateral | Polyps = unilateral

Question 37

If you see peritonsilar abscesses, what organism should you think?

Answer 37

Strep

Question 38

Sx = change of voice and progressive hoarseness

Answer 38

Reactive nodules

Question 39

Smooth, raspberry-like proliferations on the true vocal cords

Answer 39

Squamous papilloma

Question 40

Recurring papillomas in adulthood are often due to ___?

Answer 40

HPV type 6 and 11

Question 41

What type of cancer makes up over 95% of laryngeal cancers?

Answer 41

SCC

Question 42

Histology = pearly gray, wrinkled plaques on mucosal surface that ulcerate and fungate

Answer 42

Carcinoma of the larynx (SCC)

Question 43

What is the common presentation, age, and sex for Carcinoma of the larynx (SCC)?

Answer 43

Sx = hoarseness, dysphagia, dysphonia | men, > 60 yo

Question 44

If smoking ceases prior to dysplasia of the epithelium in the larynx, what happens?

Answer 44

Regression occurs

Question 45

What are the most common bacteria causing ear infections?

Answer 45

S. Pneumoniae, Non-typeable H. Influenzae, M. Catarrhalis

Question 46

What are the most common causes of chronic otitis?

Answer 46

Pseudomonas, S. Aureus, Fungi

Question 47

What organisms cause Bullous Myringitis?

Answer 47

S. Pneumoniae, M. Pneumoniae

Question 48

Histology = Non-neoplastic cystic lesion lined by keratinizing squamous epithelium and filled with amorphous debris

Answer 48

Cholesteatoma

Question 49

What are Cholesteatomas associated with?

Answer 49

Otitis media | Invasion into adjacent structures

Question 50

Carcinomas of the ear occur in what population and because of what?

Answer 50

Elderly men | Sun exposure

Question 51

Suppurative destruction of the lung parenchyma with a central area of cavitation

Answer 51

Lung abscess