ENT Pathology I

Question 1

schneiderian mucosa

Answer 1

line nasal cavity and rhinonasal sinuses

Question 2

sinonasal respiratory mucosa

Answer 2

• ciliated pseudostratified columnar cells
• mucin-containing goblet cells
• basal cells

Question 3

green mucus

Answer 3

bacterial

Question 4

acute rhinitis

Answer 4

will go away in week

may progress - pharyngitis, sinusitis, otitis media

Question 5

coryza

Answer 5

inflammation of mucous membrane of nose

Question 6

majority of acute rhintis

Answer 6

colds - viruses

rhinoviruses
-picornaviruses, ss-RNA, enterovirus

also adenovirus, echovirus, coronarvirus, parainfluenza, RSV

Question 7

RAST testing

Answer 7

of allergens

Question 8

allergic rhintis

Answer 8

hay fever

-rhinorrhea, sneezing, congestions, itching

Question 9

seasonal hay fever

Answer 9

particular time of year

Question 10

perennial hay fever

Answer 10

all year round

Question 11

episodic hay fever

Answer 11

bouts at irregular intervals

Question 12

hay fever

Answer 12

type I hypersensitivity

• IgE mediated
• Th2 response
• early - mast cells/histamine
• late - eosinophils

Question 13

most common eosionphilia in US

Answer 13

allergies

other nations - parasites

Question 14

chronic rhintis

Answer 14

longer than 1 months of symptoms

common with polyps or deviated septum

typical onset - after age 20

Sx
1 sneezing
2 rhinorrhea
3 nasal congestion
4 postnasal drainage

Question 15

nasal polyps

Answer 15

with recurrent rhintis
-may cause obstruction

edematous tissue with eosinophils

Question 16

maxillary sinus

Answer 16

can get infection through resp tract AND the mouth

Question 17

sinusitis

Answer 17

inflammation of sinus with associated nasal mucosa often

aka rhinosinusitis

Question 18

acute rhinosinusitis

Answer 18

< 1 month

Question 19

subacute rhinosinusitis

Answer 19

1-3 months

Question 20

chronic rhinosinusitis

Answer 20

> 3 months

Question 21

mucocele of sinus

Answer 21

mucus blockage of sinus

in rhinosinusitis

Question 22

facial pain, pressure, congestions

Answer 22

sinusitis

acute - has fever
-may spread to bone - osteomyelitis

Question 23

acute viral infectious sinusitis

Answer 23

clears 7 days or less

-rhinovirus, influenzavirus, parainfluenzavirus

Question 24

acute bacterial infectious sinusitis

Answer 24

complication of viral sometimes

streptococcus pneumoniae
haem influenza
moraxella catarrhalis (kids)

Sx more than 7 days**
Sx get worse**
associated with dental disease**

Question 25

ASA triad**

Answer 25

chronic rhinosinusitis, nasal polyp, severe bronchial asthma allergic rxn to aspirin

Question 26

majority of chronic obstructive sinusitis

Answer 26

obstructive

Question 27

kartagener syndrome

Answer 27

immotile cilia -situs inversus possible can lead to chronic obstructive sinusitis

Question 28

diabetics

Answer 28

high glucose - fungal infections in chronic obstructive sinusitis

Question 29

bacteria in chronic obstructive sinusitis

Answer 29

staph aureus majority

Question 30

allergic mucus

Answer 30

recurrent sinusitis with lots eosinos with no organisms present

Question 31

charcot leyden crystals

Answer 31

eosinophil mucus

Question 32

allergic fungal sinusitis

Answer 32

recurrent sinusitis - with eosino mucus with fungi

Question 33

fungal ball

Answer 33

mycetoma fungal organisms, scant mucus, little inflammation see mass lesion by Xray in sinus cavity

Question 34

invasive fungal sinusitis

Answer 34

severe sinusitis -neuro deficit fungal organisms INVADE tissues and vessels

Question 35

wegeners granulomatosis

Answer 35

granulomatosis with polyangiitis c-ANCA PR53

Question 36

cocaine

Answer 36

vasoconstrictor -perforated septum necrotizing to upper airways

Question 37

diabetic, chronic sinusitis, swelling around face, HAs

Answer 37

rhinocerebral mucormycosis in immunocompromised -mucor - does not pick up silver stain

Question 38

hansen disease

Answer 38

lepromatous leprosy mycobacterium leprosy can lead to necrotizing lesions of upper airways

Question 39

NK-T cell lymphoma

Answer 39

malignant lymphocytes -go to wall of vessel lumen compromised midline - nose to testis

Question 40

broad hyphae in diabetic

Answer 40

mucor rhinocerebral mucormycosis mucor - likes iron - diabetics hav higher iron content

Question 41

18yo M, unilateral nasal obstruction, epistaxis, swelling of face, eye, cheek

Answer 41

nasopharyngeal angiofibroma benign highly vascularized posterolateral wall

Question 42

nasopharyngeal angiofibroma

Answer 42

``` posterolateral highly vascularized benign young males epistaxis ``` Tx - surgical resection - presurgical embolization of vessels

Question 43

exophytic schneiderian papilloma

Answer 43

septal** squamous majority associated with HPV Tx - resection 20-50yo M fugiform villous formation

Question 44

schneiderian benign neoplasms

Answer 44

nasal cavity and septum

Question 45

inverted schneiderian papilloma

Answer 45

lateral** -near middle turbinate squamous harder to resect - can become malignant associated with HPV 40-70yo M squamous epithelium invaginates into lining

Question 46

oncocytic schneiderian papilloma

Answer 46

lateral** cylindrical/columnar > 50yo no HPV associated abundant bright pink cytoplasm - oncocytic some to invasive carcinoma

Question 47

squamous papilloma

Answer 47

wart in nose - verruca vulgaris - anteior in nose toward nares more common than schneiderian tumors

Question 48

esthesioneuroblastoma

Answer 48

olfactory neuroblastoma -from neuroendocrine cells top of nose see neuro markers 5 years survival 40-90% Tx - surgery

Question 49

small blue cell tumor

Answer 49

olfactory neuroblastoma

Question 50

SYP, NSE, chronogrannin, CD55/57

Answer 50

markers for neuroendocrine tumors synaptophysin neuron specific enolase

Question 51

tumor top of nose in back, small blue cells, neuro markers

Answer 51

esthesioneuroblastoma

Question 52

nasopharynx

Answer 52

non-keratinizing squamous and resp epithelium

Question 53

oropharynx and laryngopharynx

Answer 53

100% non-keratinizing squamous