Head & Neck - Nasal Cavity & Ears Flashcards
1
Q
infectious rhinitis
- effects what part of the respiratory tract
- is caused by what agents?
- can turn into what?
A
- the nasal cavity
- viruses: common cold agents -> adeno, echo, rhino
- can become:
- pharyngotonsillitis (by extension)
- secondary bacterial infection
- nasal polyps
2
Q
allergic rhinitis
- effects what part of the respiratory tract?
- is cause by what agents?
- can become what?
A
- nasal cavity
- allergens - plan pollens, fungi, dust mites:
- –> IgE mediated reaction
- can cause nasal polyps
3
Q
what is the diagnostic difference between infectious and allergic rhinitis?
A
in a nasal smear of allergic rhinitis, you would see eiosinophils (vs infectious, where you’d see more lmphocytes )
4
Q
how long does infectious rhinitis last if treated?
A
1 week
5
Q
nasal polyps
- have what cause/pathogenesis?
- have what gross/microscopic appearance?
- are particularly common in what population?
A
- typically follow recurrent attacks of rhinitis (infectious or allergic), after which buildup of inflammation/inflammatory cells make –> focal protrusions of mucosa (3-4 cm)
- gross:
- shimmering, shining bump
- microscopic:
- respiratory (ciliated pseudostratified columnar) epithelial lining
-
edematous, loose stroma (white color)
- contain inflammatory cells
- +/- hyperplastic/cystic mucous glands
- common in in children with cystic fibrosis*
6
Q
chronic rhinitis
- has what cause/pathogenesis?
- is exacerbated by what other issues?
A
- seqel to repeated acute rhinitis (allergic or infectious) attacks
- with eventual development of sumperimposed bacterial infection. inflammation creates “petri dish” for bacteria to fester
- a deviated septum or nasal polyp increase the likelihood of said infection
7
Q
acute sinsusitis
- what is it?
- what is it cause/pathogenesis?
- what can it lead to?
A
- infection of the sinuses
- causes:
- most often, due to rhinitis (either chronic or acute)
- less often, arises by extension of a periapical (dental) infection thru the bony floor of sinus - i.e., maxillary sinusitis
- repeated bouts –> chronic sinusitis
8
Q
chronic sinusitis
- cause/pathogenesis
- subtypes of chronic sinusitis?
- complications
A
- cause: repeated bouts of acute sinusitis that are
- typically due to inhabitants of the oral cavity - develops into –> chronic
- typically involves some kind of outflow obstruction (mucosal inflammation, polyps) that inhibits purging of infection
- typically due to inhabitants of the oral cavity - develops into –> chronic
- subtypes:
- allergic fungal sinusitis (asperilligus)
- severe chronic sinusitis (invasive fungi)
- complications:
- empyma (mucocele)
- osteomyelitis
- septic thromophlebitis or dural venous sinus
9
Q
what are the complications of chronic sinusitis?
A
- empyma (mucocele) - suppurative exudate formed mostly by blockage of the frontal (or sometimes ant. ethmoid) sinuses
- osteomyelitis - of surrouding bone
- septic thromophlebitis of the dural venous sinus
10
Q
allergic fungal sinusitis
- acute/chronic?
- due to what fungal agent?
- has what microscopic presentation?
- is prevalent in what populations?
A
- type of chronic sinusitis
- agent: asperilligus
- histology: “allergic mucin”
- sloughed epithelial cells
- charot-layden crystals
- eisonophils
- funal hyphae
- seen in immunocompetent (healthy) populations
11
Q
severe chronic sinusitis
- chronic/acute?
- caused by what etiological agents?
- is seen in what populations?
A
- chronic sinutiis
- due to invasive fungi - ex: mucormyocosis
- seen mostly in diabetes patients
12
Q
what is Kartagener synrome?
- etiology?
- inheritence pattern?
- complications?
A
- a rare cause of chronic sinusitis
- primary ciliary dyskinesa - causes dynein arm absence/anormalities
- autosomal recessive
- can lead to:
- situs inversus
- bronchiectasis
- infertility
13
Q
what is shown in this picture?
what cause it?
A
- a mucocelce (empyema)
- a complication of severe chronic sinusitis (mucormycosis)
- due to an accumulation of suppurative exudative likely from blockage of the frontal/ant. ethnmoid sinuses
14
Q
what three diseases are the major causes of necrotizing lesions of the nose/upperairways?
A
mucormycosis
graunlomatosus with polyangitis
extranodal NK/T-cell lymphoma
15
Q
mucormycosis
- can cause what disease(s)?
- is most likely to effect what populations?
- has what presentation?
A
- can cause
- severe fungal chronic sinusitis
- necrotizing lesions (in nose/upper airway)
- mostly effects diabetic & immunocompromised patients
16
Q
granulomatosis with polyangitis (Wegner’s)
- has what cause/pathognesis?
- can lead to what disease(s)?
- is diagnosed how?
A
- cause: autoimmune - inhaled antigens induce a T-cell mediated reaction
- can lead to:
- necrotizing granulomas (in nose / palate / pharnyx)
- necrotizing vasculitis of small/medium vessels –> alveolar hemorphage
- glomerulonephritis
- dx: c-ANCA against PR3 or MPO
17
Q
extranodal NK/T-cell lymphoma
- has what cause/pathogenesis?
- causes what disease(s)?
- effects what demographic
A
- caused by lymphoma tumor cells that harbor EBV
- leads to nasal type necrotizing lesions (nose/upper airways)
- demographics:
- men in 5th/6th decade
- asian/latin american descent
20
Q
discuss the microsophic characteristics of nasopharyngeal angiofibroma
A
- presence of “ staghorn antlers“
- microscopically resembles erectile tissue
21
Q
sinonasal papillomas
- benign/malignant?
- arise from what tissue?
- has what characteristics/associations?
- is seen in what demograhics?
A
- benign
- arises from respiratory mucosa
- HPV DNA (types 6 and 11) are often isolated from the papillomas, especially exo and endophytic forms
- exophytic (most common)
- endophytic - can become malignant
- demographic: males 30-60
22
Q
olfactory neuroblastomas
- benign/malignant
- arises from what tissue?
- has what associations/characteristics?
- has what sequelae?
- effects what demographics?
A
- benign
- from neuroectodermal olfactory cells (esp superior aspect of nasal cavity mucosa)
- associations: express neuroendocrine markers (ex: chromagramin)
- sequelae:
- NOSE BLEEDS (EPISTAXIS)
- NASAL OBSTRUCTION
- demographic: bimodal peak at 15 & 50 yrs
