ENT Pathology

Question 1

Vincent angina

Answer 1

acute necrotizing ulcerative gingivitis/ pharyngitis. punched out erosions of interdental papilla. necrotic pseudomembrane.

Question 2

ludwig angina

Answer 2

spreading cellulitis after dental extraction in sublingual or submandibular space. Can cause airway obstruct (esp. in kids) and dysphagia. Swelling under chin. neck stiffness

Question 3

herpes ulcer vs. apthous stomatitis sore

Answer 3

herpes ulcerate then ruptures and is recurring. AS ulcer but don’t rupture and are painful, caused by stress.

Question 4

EBV nasophryngeal cancer type

Answer 4

non-keretinized type

Question 5

Herpangina

Answer 5

coxsackie virus. vesicular oropharyngitis.

Question 6

most common salivary gland tumor

Answer 6

pleomorphic adenoma (mixed). usually parotid. Made of myoepithelial and stromal elements. have fibrous capsule and grown into surrounding tissue. painless moveable mass.

Question 7

Hemangioma

Answer 7

pregnancy tumor. blood vessel tumor. benign build up or growth of epithelial cells that line blood vessels. friable and bleed often.

Question 8

Diff between canidiasis and leukoplakia

Answer 8

leukoplakia is adherent to tongue (hyper-keratosis) while canidiasis can be scraped off. Leuko often seen in smokers.

Question 9

Most common malig tumor of oral mucosa

Answer 9

Squamous cell carcinoma.

Question 10

Aspirin intolerance, asthma and allergies…think

Answer 10

Nasal polyps. from allergic rhinitis, IgE present with eosinophils. associ. with diabetes and CF. Respiratory epithelial with loose mucoid stroma

Question 11

Most common malig tumor or nasal mucosa

Answer 11

Squamous cell carcinoma. Invade adjacent structures and grow quickly

Question 12

Olfactory neuroblastoma

Answer 12

neural crest origin. can destroy bone. malignant

Question 13

NK/T-cell lymphoma

Answer 13

necrotizing, ulceration mucosal lesions of URT. assoc with EBV. is Angioinvasive, – occludes vessels.. black crusty ulcers. defects in nasal septum and palates.

Question 14

nasopharyngeal angiofibroma

Answer 14

Adolescent males. locally invasive will erode bone. respond to estrogen. linked to FAP (Familial Adenamoatous Polyplosis)

Question 15

Oropharyngeal SCC

Answer 15

usually assoc with HPV. non-keratinizing.

Question 16

nasopharyngeal carcinoma

Answer 16

usually asymptomatic for long time, notice in cervical lymph node first.

Question 17

Lymphoma of waldeyer ring

Answer 17

diffuse B cell

Question 18

Chordomas

Answer 18

embryonic notochord remnants

Question 19

sialolithiasis

Answer 19

calcified stone in salivary duct

Question 20

warthin tumor

Answer 20

benign parotid tumor. cystic glandular spaces embedded in dense lymphoid tissue. bilateral or multifocal within same gland

Question 21

mucoepidermoid carcinoma

Answer 21

glandular and squamous cells. from ductal epithelium. slow growing. firm, painless.

Question 22

adenoid cystic carcinoma

Answer 22

invade locally and often RECUR after resection. infiltrate perineural space and cause pain. cribifrom (sieve like) growth.

Question 23

Subperichondrial hematomas that deform ears

Answer 23

Cauliflower ears. below cartilege

Question 24

replasping polychondritis

Answer 24

cartilage in body destroyed and replaced by granulation tissue. prob autoimmune.

Question 25

cholesterol granuloma vs cholesteatoma

Answer 25

CG - from chronic otitis media - extravasated RBC liberate cholesterol, foreign body response, granuloma. C-toma – perforated ear drum can lead to this. keratin and squamous mass growing into middle ear which can become infected

Question 26

most common benign tumor or middle ear

Answer 26

jugulotympanic paraganglioma. slow growing. lobules of cells

Question 27

Otosclerosis

Answer 27

inherited. most common cause of conductive hearing loss. resorptioni of bone, osteoclasts remodel bone – occurs at oval window and spreads to affect stapes

Question 28

vertigo, sensorineural hearing loss and tinnitus

Answer 28

meniere dx. Endolymph fluid in labyrinth (semi-circ canals) –> balance/vertigo. swelling of cochlear endolymph –> hearing loss. tx. low salt and diuretics.

Question 29

Bilateral congenital hearing loss caused by

Answer 29

Rubella

Question 30

most common post natal virus causing unilateral deafness

Answer 30

mumps

Question 31

acoustic trauma occurs due to

Answer 31

destroy hair cells

Question 32

Most common tumor of inner ear

Answer 32

Schwannoma. slow growing, slow vestibular and auditory symptoms.

Question 33

aphthous stomatitis

Answer 33

painful recurrent solitary or multiple (kids) small ulcers of oral mucosa. shallow ulcer covered by fibrinopurulent exudate

Question 34

Pyogenic granuloma

Answer 34

reactive vascular lesion. minor trauma to tissue permits invasion of microorganisms. most frequent on gingiva. elevated red or purple soft mass with smooth lovbulated ulcertated surface. highly vascular granulation tissue showing inflammation (acute or chronic). with time comes to resemble a fibroma due to dec. vascularization.

Question 35

causative agent: oropharyngeal SCC

Answer 35

HPV 16, 18. malignant

Question 36

causative agent: Nasal papilloma

Answer 36

HPV 6, 11 benign

Question 37

causative agent: Nasopharyngeal carcinoma

Answer 37

EBV malignant non-keritinized

Question 38

causative agent: oral hairy leukoplakia

Answer 38

EBV

Question 39

Foamy macrophages, Mikulicz cells

Answer 39

Rhinoscleroma from Klebsiella

Question 40

causative agent: Nasal polyp

Answer 40

chronic rhinitis

Question 41

most common laryngeal carcinoma

Answer 41

SCC. smokers.

Question 42

Malignant ottitis externa

Answer 42

infection of external audiotry canal by Pseudomonos aerguniosa. Can spread via mastoids. Assoc. DIABETICS. presents as ear pain, fever, granulation tissue in canal

Question 43

Aural Polyps

Answer 43

beign inflam lesions in external ear canal. Ulcerated and inflammd granulation tissue which bleeds. Caused by chronic otitis media.