ENT pathology

Question 1

What lines the auditory meatus and external canal?

Answer 1

Epidermis (skin)

Question 2

What lines the middle ear?

Answer 2

Columnar lined mucousa

Question 3

What is the other name for the mucosa that lines the nose/sinuses?

Answer 3

Schneiderian epithelium (same as squamous)

Question 4

What are the 2 components of a salivary gland?

Answer 4

Acinar component

Ductular component

Question 5

What are serous cells?

Answer 5

Darklu staining cells that contain digestive enzymes (amylase etc.)

Question 6

What is OM?

Answer 6

Inflammation of the middle ear

Question 7

Most common bacterial causes of OM

Answer 7

Strep. pneumonaie
H. influenzae
Moxarella Catarrhalis

Question 8

What is the most likely causative organism if OM is chronic?

Answer 8

Pseudomonas aerguinosa

Question 9

What is a cholesteatoma?

Answer 9

Squamous epithelium in the middle ear (should be columnar)

Question 10

What other histological findings are consistent with cholesteatoma?

Answer 10

High cell turnober
Abundant keratin production
Associated inflammation

Question 11

What is the pathogenesis of cholesteatoma?

Answer 11

Chronic OM and perforated tympanic membrane

Question 12

Where do vestibular schwannomas occur?

Answer 12

Within the temporal bone

Question 13

If bilateral vestibular schwannomas in a young patient what should be considered?

Answer 13

NF type II

Question 14

What is the inheritance pattern of NF type I?.

Answer 14

Autosomal dominant

Question 15

Clinical presentation of NF type I?

Answer 15

Widespread neurofibromas 
Bony defects 
Cafe au lait spots 
Axillary freckling 
Lisch nodules (eyes)

Question 16

What is the inheritance pattern of NF type II?

Answer 16

AD but usually sporadic

Question 17

Clinical presentation of NF type II?

Answer 17

Bilateral vestibular schwannoma
Multiple meningiomas
Gliomas
Cafe au lait

Question 18

What should be considered in nasal polyps in young children?

Answer 18

CF

Question 19

Aetiologies of nasal polyps

Answer 19

Allergy 
Infection 
Asthma 
Aspirin sensitivity 
Nickel exposure

Question 20

Features of nasal polyps

Answer 20

Fluid filled sacs (“red grapes”) up nose

Not painful

Question 21

What type of reaction is allergic rhinitis?

Answer 21

IgE mediated type 1 hypersensitivity reaction

Question 22

What is Wegners?

Answer 22

Small vessel vasculitis limitied to respiratory tract and kidneys

Question 23

Clinical presentation of Wegners?

Answer 23

Pulmonary
Renal disease
Nasal symptoms of congestion, septal perforation

Question 24

Examples of benign lesions of the nose

Answer 24

Squamous papillomas
“Schneiderian” papillomas
Angiofibromas

Question 25

What is the most common malignant lesion of the nose?

Answer 25

Squamous cell carcinoma

Question 26

Other examples of malignant lesions of the nose

Answer 26

Primary adenocarcinoma Nasopharyngeal carcinoma Neuroblastoma Lymhoma

Question 27

What is the likely presentation of nasopharyngeal carcinoma?

Answer 27

High incidence in far east Males Strong association with EBV

Question 28

What are laryngeal polyps

Answer 28

Reactive change in the laryngeal mucosa

Question 29

Causes of laryngeal polyps

Answer 29

Vocal abuse Infection Smoking (occasionally hypothyroidism)

Question 30

What is the difference between laryngeal nodules & polyps?

Answer 30

Nothing (they are interchangable terms)

Question 31

Presentation of laryngeal polyps

Answer 31

Young women | Unilateral & predunculated

Question 32

What is a contact ulcer?

Answer 32

Benign response to injry

Question 33

Causes of contact ulcers

Answer 33

Chronic throat/voice abuse | GOrd

Question 34

What age do squamous papillomas tend to arise in?

Answer 34

> 5 years OR 20-24 years

Question 35

What is squamous papilloma related to?

Answer 35

HPV exposure (types 6 and 11)

Question 36

Are squamous papillomas more aggressive in children or adults?

Answer 36

Children

Question 37

What are paragangliomas?

Answer 37

Rare tumours arising in clusters of neuroendocrine cells dispersed throughout the body

Question 38

What 2 categories are paragangliomas split into?

Answer 38

Chromaffin positive | Non-chromaffin

Question 39

What are chromaffin positive paragangliomas?

Answer 39

Sympathetic nervous system tumours than can secrete catecholamines

Question 40

Where are chromaffin positive paragangliomas usually found?

Answer 40

Adrenal meddula | Paravertebral (organ of Zuckerkandl)

Question 41

What are paragangliomas often occuring as part of?

Answer 41

MEN

Question 42

Risk factors for squamous cell carcinoma

Answer 42

Smoking & alcohol

Question 43

What are the majority of squamous cell carcinomas associated with?

Answer 43

HPV type 16

Question 44

What is sialolithiasis?

Answer 44

Salivary gland stones

Question 45

What does paramyovirus cause?

Answer 45

Mumps Bilateral parotiditis Orchitis

Question 46

What is there a risk of with paramyovirus?

Answer 46

Secondayr meningitis

Question 47

Which salivary gland is the most common site for almost all tumour?

Answer 47

Parotid gland

Question 48

What is the most common salivary gland tumour?

Answer 48

Pleomorphic adenoma

Question 49

Who usually presents with a pleomorphic adenoma?

Answer 49

Females over 60 in parotid with long history

Question 50

What is the second most common benign salivary tumour?

Answer 50

Warthin'[s tumour

Question 51

What are the association with Warthin's tumour?

Answer 51

Males oer 50 Rare outwith parotid Strong association with smoking Often bilateral& multicentric

Question 52

What is the most common malignant tumour of the salivary gland in the UK?

Answer 52

Adenoid cystic carcinoma

Question 53

Which cancers is EBV associated with?

Answer 53

Burkitt's lymphoma ther B-vell lymphomas Hodgkin's lymphoma