General

Question 1

Disease that presents with glossitis, esophageal dysphagia, and iron deficiency anemia

Answer 1

Plummer-vinson syndrome

Question 2

What deficiencies can cause glossitis?

Answer 2

B12 deficiency
Iron deficiency
Riboflavin (B2)
Niacin (B3)
Pyridoxine (B6)

Question 3

What is hairy leukoplakia indicative of?

Answer 3

Positive infection of HIV

Question 4

What is the progression for Head/Neck Squamous Cell Carcinoma?

Answer 4

1) Loss of chromosomal regions 3p and 9p21 = inactivation of p16
2) Loss of chromosomal region 17p = inactivation of p51
3) Alterations of chromosomal regions 4, 6, 8, 13, and 14
4) Over expression of cyclin D1 gene on chromosome 11q13

Question 5

What virus causes red based lesions with blue/white centers in the mouth?

Answer 5

Rubeola (measles) virus

Question 6

Shallow, hyperemic ulceration covered by thin exudate (NO Vesicles)

Answer 6

Aphthouos stomatitis (cancker sore)

Question 7

Microscopic Findings: Hyperparakeratosis and acanthosis with balloon cells in the upper spinous layer
Macroscopic: Located on the lateral side of the tongue as white, confluent pathces of fluffy, hyperkeratotic thickenings

Answer 7

Hairy Leukoplakia

Question 8

What causes Hairy Leukoplakia?

Answer 8

Caused by EBV due to immuno suppression such as HIV

Question 9

Tumor that is closely assoc. with lymphatic tissue; cytokeratin positive; due to EBV infection

Answer 9

Nasopharyngeal carcinoma

Question 10

What are the three patterns of nasopharyngeal carcinoma?

Answer 10

Keratinzing squamous cell carcinoma
Nonkeratinizing squamous cell carcinoma
Undifferentiated carcinomas that have abundant non-neoplastic, syncytial nests with lymphocytitc infiltrate

Question 11

What are the differences in the radio sensitivity of nasopharyngeal carcinoma?

Answer 11

Keratinizing squamous cell carcinoma is the least radio-sensitive
Undifferentiated carcinoma is most radio-sensitive

Question 12

Where is the most common place that nasopharyngeal carcinoma presents with metastasis?

Answer 12

The cervical lymph nodes

Question 13

What group of people is nasopharnygeal carcinoma more common in?

Answer 13

Adults in China

Children in Africa

Question 14

What gene treatment has seen success in the treatment of squamous cell carcinoma of the head and neck

Answer 14

EGFR gene

Question 15

Lesions with hyperkeratosis overlying a thickened, acanthotic mucosal epithelium

Answer 15

Leukoplakia

Question 16

Cyst that is usually assoc. with unerupted teeth (3rd wisdom tooth); generally has a thin lining of epithelial tissue and chronic inflammatory cells within the connective tissue stroma

Answer 16

Dentigerous cyst

Question 17

What are the two subclasses of ondontogenic cytsts?

Answer 17

Inflammatory and developmental

Question 18

Locally aggressive cyst that is lined with stratified squamous cell epithelium and a prominent basal cell layer

Answer 18

Odontogenic keratocyst

Question 19

What should be evaluated with reoccurring odontogenic keratocysts?

Answer 19

Pt. should be evaluated for Nevoid basal cell carcinoma syndrome (Gorlin syndrome)

Question 20

Benign tumor that arises from the odontogenic epithelium

Answer 20

Ameloblastoma

Question 21

Benign tumor that arises from the odontogenic epithelium and ectomesenchyme

Answer 21

Odontoma

Question 22

Benign, highly vascularized tumor found almost exclusively in adolescent males in the nasopharynx

Answer 22

Nasopharyngeal angiofibroma

Question 23

Benign neoplasm that is associated with the presence of HPV 6 and 11. It has 3 forms (exophytic, inverted, and cylindrical); Arises from the sinonasal epithelium

Answer 23

Sinonasal papilloma

Question 24

Uncommon, malignant neoplasm consisting of small round cells arising from neuroendocrine cells most commonly in the superior and lateral aspects of the nose

Answer 24

Olfactory neuroblastoma

Question 25

Positive findings in an olfactory neuroblastoma

Answer 25

CD56, chromogranin

Question 26

What's the difference between Singers' nodules and polyps located on the vocal cords?

Answer 26

Singers' nodules are bilateral

Question 27

Paipillomas that are positive for HPV 6 and 11

Answer 27

Laryngeal squamous papillomas and Sinonasal Papillomas

Question 28

Benign, Raspberry like outgrowth found on the larynx that are caused by infection of HPV 6 and 11; often regress at puberty

Answer 28

Laryngeal squamous papilloma

Question 29

Neoplasm that can be found within the larynx or outside of it; can have varying presentation on microscopy (hyperplasia- invasive carcinoma); Most common is persistent hoarsness

Answer 29

Carcinoma of the larynx (generally squamous cell carcinoma)

Question 30

What is the most common cause of otitis media? Secondary infection?

Answer 30

``` Viral Secondary infection: Strep. pneumonae Moraxella catarrhalis Haemophilus influenzae ```

Question 31

Cause of chronic otitis media

Answer 31

Pseudomonas aeruginosa Staph. aureus Fungal

Question 32

Cystic lesion lined by keratinizing squamous epithelium or metaplastic mucus secreting epithelium associated with chronic otitis media; may have cholesterol within it

Answer 32

Cholesteatoma

Question 33

Bones of the ear

Answer 33

Malleus, Incus, Stapes Don't MIS!

Question 34

Abnormal deposition of bone in the middle ear at the rim of the oval window where the stapes attach

Answer 34

Otosclerosis

Question 35

General Differential Diagnosis for Hoarseness

Answer 35

1) Laryngitis (infection) 2) Laryngeal papilloma 3) Laryngeal webs 4) Cyst/ulcer/Polyp 5) Overuse 6) Vocal Chord paralysis 7) Post intubation granuloma 8) GERD 9) Cancer 10) Inhalation of chemicals

Question 36

What is the initial Tx for hoarseness

Answer 36

1) Voice Rest 2) No clearing of the throat 3) Stop Smoking 4) Stop alcohol intake 5) Visit speech therapist

Question 37

What is Bullous myringitis?

Answer 37

It is direct infection of the tympanic membrane only

Question 38

unilateral ear pain is __________ until proven otherwise in adults

Answer 38

cancer

Question 39

Rare cardiovocal syndrome that causes laryngeal nerve palsy from cardiovascular disease; presents with a dilated left atrium due to mitral stenosis

Answer 39

Ortner's syndrome

Question 40

Lump in throat with no physical exam findings; triggered by emotions

Answer 40

Globus hystericus

Question 41

What are the layers that are cut through to perform a cricothyrotomy?

Answer 41

1) Skin 2) Superfical cervical fascia and platysma muscle 3) Investing and pretracheal layers of the deep cervical fascia 4) Cricothyroid membrane