pathology

Question 1

what are the auditory meatus and external canal lined with?

Answer 1

epidermis (stratified squamous)

Question 2

what lines the middle ear?

Answer 2

columnar lined mucosa

Question 3

what does the middle ear contain

Answer 3

ossicles, opening of eustachian tube and mastoid cavity

Question 4

what does the inner ear contain?

Answer 4

-cochlea and vestibular apparatus

Question 5

what are the three parts of the cochlea?

Answer 5

• scala vistibuli
• cochlear duct
• scala tympani

Question 6

what detects linear movements?

Answer 6

utricle

saccule

Question 7

what is nasal vestibule made up of?

Answer 7

squamous epithelium

Question 8

what are the major/minor salivary glands?

Answer 8

major glands (paired):

• parotid
• submandibular
• sublingual

minor:
-salivary glands

Question 9

what components are slivary glands made up of?

Answer 9

acinar component and ductular component

Question 10

what cells are found in salivary glands>

Answer 10

• serous cells
• mucinous component
• ducts
• myoepithelial cells

Question 11

what is otitis media?

Answer 11

URTI involving middle ear by extension of infection of eustachian tube

Question 12

what is a cholesteatoma?

Answer 12

an abnormal collection of skin cells deep inside your ear due to abnormal keratin production usually from chronic otitis media and perforated tympanic membrane

Question 13

who is otitis media more common in?

Answer 13

children

Question 14

how do you get otitis media?

Answer 14

usually viral

Ocasionally bacterial:

• strep, pneumonia
• H.influenze
• moraxella
• strep.pyogenes

Question 15

who do cholesteatoma usually affect?

Answer 15

• common
• any age
• more commonly male

Question 16

pathogenesis of aquired cholesteatoma?

Answer 16

chronic otitis media and perforated tympanic membrane

Question 17

pathogenesis of congenital cholesteatoma?

Answer 17

proliferation of embryonic rest

Question 18

what are majority of ear tumours?

Answer 18

SCC

Question 19

pathogenesis of ear tumours?

Answer 19

related to chronic inflammation or radiation

Question 20

most common tumour of temporal bone?

Answer 20

vestibular schwannoma

Question 21

are vestibular schwannoma usually bilateral?

Answer 21

no- unilateral and sporadic (95%)

Question 22

what would you consider if you found bilateral vestibular schwannoma in young patient?

Answer 22

consider neurofibromatosis (NF) type 2

Question 23

what is rhinitis?

Answer 23

infectious rhinitis= common cold (viral)

allergic rhinitis= hay fever (IgE mediated type 1 hypersensitivty reaction)

Question 24

what causes sinusitis?

Answer 24

• can be due to dental problem

- usually following rhinitis

Question 25

who are nasal polyps found in?

Answer 25

common (not children) equal sex distrubution associated with cystic fibrosis

Question 26

what is ganulomatosis with polyangitis?

Answer 26

- small vessel vasculitis wiht necrosis - rare - more common in men - ENT problems - renal disease

Question 27

what antibodies are associated with GPA?

Answer 27

cANCA

Question 28

what are most common benign nasal lesions?

Answer 28

squamous cell papillomas

Question 29

what are most common malignant nasal lesions?

Answer 29

SSC

Question 30

what are the 3 types of sinonasal papilloma?

Answer 30

inverted, exophytic and oncocytic

Question 31

who are sinonasal papillomas usually seen in?

Answer 31

>50s males HPV

Question 32

what are symptoms of sinonasal papillomas ?

Answer 32

blocked nose

Question 33

sinonasal papillomas malingant or benign?

Answer 33

benign- dont often undergo malignant change

Question 34

who are nasopharyngeal carcinomas usually seen in?

Answer 34

``` males Epstein virus FH smoking alcohol HPV working with wood, dust ```

Question 35

what are the types of nasopharyngeal carcinomas

Answer 35

keratinising SCC (more aggresive locally but less likely to metastasize) non keratinising SCC baseloid SCC

Question 36

what are laryngeal polyps?

Answer 36

- reactive chnage in laryngeal mucosa secondary to vocal abuse, infection and smoking - asociated with hypothyroidism

Question 37

what are contact ulcers?

Answer 37

benign response to injury found posterior vocal cord

Question 38

what is the most common benign disease of the larynx?

Answer 38

squamous cell papilloma/papillomatosis

Question 39

what are squamous cell papilloma/papillomatosis associated with?

Answer 39

HPV exposure

Question 40

when do squamous cell papillomas/papillomatosis usually occur?

Answer 40

<5 years | between 20-40

Question 41

are squamous cell papillomas agressive?

Answer 41

in children yes | in adults they are often solitary

Question 42

what are paragangliomas?

Answer 42

tumours arising from neuroendocrine cells dispersed throughout the body

Question 43

what is a paraganglioma in adrenal glands called?

Answer 43

pheochromocytoma

Question 44

what are the most common tumours in the head and neck?

Answer 44

SCC

Question 45

what are risk factors for SCC?

Answer 45

smoking, alcohol, HPV

Question 46

how does SCC develop?

Answer 46

- hyperplasia - dysplasia - malignancy

Question 47

what type of HPV are most cases of HPV associated with?

Answer 47

HPV type 16

Question 48

pathophysiology of HPV?

Answer 48

produces proteins E6 and E7 which disrupts p53 and RB pathways respectively, leading to cellular immortality

Question 49

what are sialolithiasis?

Answer 49

stones within salivary glands

Question 50

what salivary gland most commonly has tumours?

Answer 50

parotid

Question 51

in what salivary glands are tumours more often malignant?

Answer 51

smaller glands

Question 52

how can you tell if salivary gland is probably malignant?

Answer 52

-if young and the mass is painful

Question 53

what are the most common salivary tumour?

Answer 53

pleomorphic adenoma

Question 54

where are pleomorphic adenoma usually found?

Answer 54

parotid but can be found any salivary gland

Question 55

are pleomorphic adenoma malignant?

Answer 55

can be benign or malignant

Question 56

who does pleomorphic adenoma commonly occur in?

Answer 56

- females | - 30 to 60

Question 57

what are the second most common benign tumour in salivary gland?

Answer 57

warthins tumour

Question 58

who are warthins tumour more common in?

Answer 58

- men | - smokers

Question 59

is mucoepidermoid carcinoma benign or malingnant?

Answer 59

malignant

Question 60

where are mucoepidermoid carcinoma typically found?

Answer 60

parotid but can occur in any salivary gland

Question 61

what are mucoepidermoid carcinoma associated with?

Answer 61

MECT1-MAML2 fusion

Question 62

are adenoid cystic carcinomas benign or malignant?

Answer 62

malignant (most common of palate)

Question 63

how does otitis media present?

Answer 63

- ear ache - discharge - hearing loss - lethargy - fever - red swollen ear drum on inspection

Question 64

what investigations are done for otitis media?

Answer 64

if ear drum perforates swab and test most common bacteria: - Strep pnemoniae - H. influenza - Moraxella - Strep pyogenes

Question 65

treatment for otitis media?

Answer 65

80% resolve in 4 days without antibiotics 1st line= amoxicillin 2nd line= erythromycin

Question 66

how does cholesteatoma present?

Answer 66

- usually only one ear affected - persistent or recurring watery, often smelly, discharge from the ear which can come and go or be continuous - a gradual hearing loss

Question 67

what is the investigations done for cholesteatoma?

Answer 67

diffusion weight MRI

Question 68

what is the management for cholesteoma?

Answer 68

surgery