Pathology

Question 1

What is otitis media?

Answer 1

Inflammation of the middle ear that occurs mostly in children

Question 2

What are some bacterial causes of otitis media?

Answer 2

Strep. pneumoniae
H. influenzae

Question 3

What are the main causative organisms of chronic otitis media?

Answer 3

Pseudomonas aeruginosa
Staph aureus

Question 4

What is cholesteatoma?

Answer 4

Growth consisting of keratinizing squamous epithelium in the middle ear +/- mastoid process

Question 5

What causes acquired cholesteatoma?

Answer 5

Chronic otitis media
Perforated tympanic membrane

Question 6

What causes congenital cholesteatoma?

Answer 6

Proliferation of embryonic rest

Question 7

How does a macro cholesteatoma present in the ear?

Answer 7

A pearly white mass in the middle ear

Question 8

How does a micro cholesteatoma present in the ear?

Answer 8

Squamous epithelium with abundant keratin production, associated with inflammation

Question 9

What diagnosis makes up the majority of ear tumours?

Answer 9

Squamous cell carcinoma

Question 10

What nerve is associated with a vestibular schwannoma?

Answer 10

Vestibular portion of the vestibulocochlear nerve (VIII)

Question 11

Where do vestibular scwhannomas occur?

Answer 11

Within the temporal bone

Question 12

What should be considered in a young patient with bilateral vestibular scwannomas?

Answer 12

Neurofibromatosis T2

Question 13

What are the main aetiologies for nasal polyps?

Answer 13

Allergy, infection, asthma, aspirin sensitivity and nickel exposure

Question 14

What are micro nasal polyps associated with?

Answer 14

Allergic aetiologies associated with eosinophils

Question 15

What is granulomatosis with polyangiitis characterised by?

Answer 15

Small vessel vasculitis and necrosis typically limited to the respiratory tract and kidneys

Question 16

How does GPA present?

Answer 16

Respiratory symptoms
Renal disease
Nasal symptoms of congestion

Question 17

What is the most common benign tumours of the nose?

Answer 17

Squamous cell papillomas

Question 18

What is the most common malignant nose tumour?

Answer 18

Squamous cell carcinoma

Question 19

What are the three types of sinonasal papilloma?

Answer 19

Inverted
Exophytic
Oncocytic

Question 20

What is the main aetiology of sinonasal papilloma?

Answer 20

Low risk HPV

Question 21

Where are nasopharyngeal carcinomas more likely to occur?

Answer 21

Far east and parts of Africa

Question 22

What is nasopharyngeal carcinoma associated with?

Answer 22

EBV
Volatile nitrosamines in food

Question 23

What causes laryngeal polyps?

Answer 23

A reactive change in laryngeal mucosa secondary to vocal abuse, infection and smoking

Question 24

What causes contact ulcers?

Answer 24

A benign response to injury - chronic throat clearing, voice abuse, GORD, intubation etc.

Question 25

What does EBV virus do?

Answer 25

EBV genes 'hi-jack' normal signalling pathways

Question 26

How does macro squamous cell papilloma of the throat present?

Answer 26

An exophytic, sessile or pedunculated mass

Question 27

How does micro squamous cell papilloma of the throat present?

Answer 27

Finger-like projection A fibrovascular core covered by stratified squamous epithelium

Question 28

What is the most common tumour seen in the head and neck?

Answer 28

Squamous cell carcinoma

Question 29

Where is the most common site of squamous cell carcinoma in the head and neck?

Answer 29

Oropharynx

Question 30

What are the main risk factors for squamous cell carcinoma in the head and neck?

Answer 30

Smoking and alcohol

Question 31

How does HPV lead to tumour development?

Answer 31

Increased expression of proteins E6 and E7 which disrupt p53 and RB pathways respectively This leads to cellular immortality - preventing apoptosis

Question 32

What are sialolithiasis?

Answer 32

Stones in the salivary glands

Question 33

What is a common viral infection of the salivary glands?

Answer 33

Mumps - paramyxoma virus

Question 34

What is the most common site in salivary glands for tumours to occur?

Answer 34

Parotid gland

Question 35

Which salivary gland tumours are most likely to be malignant?

Answer 35

Tumours of smaller salivary glands (submandibular / sublingual)

Question 36

What is the most common benign tumour of the salivary glands?

Answer 36

Pleomorphic adenoma

Question 37

What are the common symptoms of sialolithiasis?

Answer 37

Blocking and pain of salivary glands

Question 38

What is the second most common benign tumour of the salivary glands?

Answer 38

Warthin's tumour

Question 39

What are Warthin's tumours strongly associated with?

Answer 39

Smoking

Question 40

What is the most common malignant tumour of the salivary glands worldwide?

Answer 40

Mucoepidermoid carcinoma

Question 41

What is the most common malignant tumour of the salivary glands in the UK?

Answer 41

Adenoid cystic carcinoma