oral cavity

Question 1

dysplasia

Answer 1

cellular atypia in the absence of invasion

potentially pre-malignant epithelial lesion

Question 2

dysplasia can occur in

Answer 2

squamous or glandular epithelium

Question 3

not all malignancy arises from dysplasia

Answer 3

many but not all carcinomas

Question 4

dysplasia grading

Answer 4

low or high grade based on the degree of nuclear atypia and architecture

Question 5

low grade dysplasia has

Answer 5

atypia, mitoses above the basal layer

evidence of dysmaturation

Question 6

high grade dysplasia

Answer 6

severe atypia, mitoses at all levels, overt evidence of abnormal architecture, no invasion

Question 7

severe dysplasia is on a spectrum with

Answer 7

carcinoma in situ

Question 8

congenital abnormalities

Answer 8

development malformation
failure of a cavity to sloe
enzyme deficiency

Question 9

meckel’s diverticulum

Answer 9

remnant of vitaline duct

pouch coming from terminal ileum

Question 10

gastroschisis

Answer 10

bowel herniates through a paraumbilical defect

Question 11

trachea-oesophageal fistula

Answer 11

passages forming between the trachea and the oesophagus

Question 12

upper aerodigestive tract

Answer 12

normally lines by respiratory epithelium in nose and sinus, transitioning to squamous epithelium in the mouth, oropharynx, parts of epiglottis

Question 13

most cancers seen in the head and neck are

Answer 13

squamous cell carcinoma

Question 14

squamous cell carcinoma

Answer 14

keratinising or non keratinising

tobacco and alcohol contribute to risk

Question 15

TNM system

Answer 15

size of tumour, nodal involvement, distant metastasis

Question 16

Head and neck tumours

Answer 16

generally poor prognosis and carries significant morbidity

Question 17

erythroplakia

Answer 17

red patch in the mouth

usually dysplastic or neoplastic regions

Question 18

leukoplakia

Answer 18

white patches in the mouth
many causes
hyperplasia, fungal, dysplasia

Question 19

risk factors for orally malignant disorders

Answer 19

tobacco, alcohol, betel nut, HPV infection, age >55, radiation exposure, UV light, some inherited syndromes

Question 20

HPV associated cancers

Answer 20

are mostly seen in the oropharynx, less commonly in the oral cavity

Question 21

high risk HPV type

Answer 21

type 16

Question 22

HPV positive head and neck cancers

Answer 22

fundamentally different molecular pathogenesis, which gives them a different morphological appearance

Question 23

nose and paranasal sinus problems

Answer 23

rhinitis 
pharyngitis 
tonsillitis 
necrotising lesions 
hyperplastic lesions 
neoplastic lesions

Question 24

acute infections rhinitis

Answer 24

the common cold
adenovirus, echovirus, rhinovirus
may progress to pharyngitis/tonsilitis

Question 25

sinusitis

Answer 25

acute - ascending infection from nose/nasopharynx/teeth | chronic: usually when there are problems with drainage

Question 26

granulomatosis with pulmonary angiitis

Answer 26

systemic inflammatory disorders aetiology not clear nodular lung lesions diffuse pulmonary haemorrhage

Question 27

hyperplastic lesions

Answer 27

nasal polyps - recurrent bouts of inflammation - oedema, fibrosis, polyp formation cause of obstruction, lead to furtherr inflammation and recurrent infections often referred to as allergic but most people with nasal polyps donut have other signs of atopic disease

Question 28

polyp

Answer 28

abnormal growth projecting from a mucous membrane usually has an epithelial lining over a stromal core can be pedunculated or sessile

Question 29

pedunculated

Answer 29

on a stalk

Question 30

sessile

Answer 30

on a broad base

Question 31

hamartomatous

Answer 31

benign proliferation of tissue native to that sire but with disorganised growth

Question 32

sinonasal papilloma

Answer 32

benign neoplasm arise from sinonasal epithelium can be exophytic or endophytic more common in males and associated with HPV

Question 33

endophytic sinonasal papilloma

Answer 33

inverted | tends to recur if not excised, can erode into orbit or cranial vault

Question 34

nasopharyngeal carcinoma

Answer 34

common in some geographical areas due to endemic EBV | eg. africa, china

Question 35

three patterns of nasopharyngeal carcinoma

Answer 35

keratinising squamous cell carcinoma non-keratinising squamous cell carcinoma undifferentiated carcinoma `

Question 36

EBV associated patterns of nasopharyngeal carcinoma

Answer 36

non-keratinising squamous cell carcinoma | undifferentiated carcinoma

Question 37

keratinising squamous cell carcinoma

Answer 37

may be high risk (type 16) HPV associated

Question 38

olfactory neuroblastoma

Answer 38

arises from neuroectoderm bimodal - peaks at ages 15 and 50 present with nasal obstruction and epistaxis locally destructive but relatively good prognosis neuroendocrine tumour

Question 39

vocal cord polyps

Answer 39

singer's nodules | - smokers - relative strain on vocal cords leads to hyperplasia

Question 40

squamous cell carcinoma of the larynx

Answer 40

similar to lung SCC smoking poor prognosis

Question 41

three major salivary glands

Answer 41

- parotid - submandibular - sublingual

Question 42

minor salivary glands

Answer 42

throughout the oral cavity