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Year 2 - ENT (DP) > Pathology > Flashcards

Pathology Flashcards

(55 cards)

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1
Q

What lines the auditory meatus and external canal?

A

Epidermis

Contains sebaceous and ceruminous glands

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2
Q

What lines the middle ear?

A

Columnar lined mucosa with glands

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3
Q

What is Schneiderian epithelium and what does it line?

A

Identical to respiratory mucosa:
- Pseudostratified ciliated columnar
- Seromucinous glands
Nose, sinus etc

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4
Q

What lines the nasal vestibule?

A

Squamous epithelium

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5
Q

What type of glands are the salivary glands?

A

Exocrine

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6
Q

What are the two components of the salivary glands?

A

Acinar

Ductular

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7
Q

How do serous cells appear?

A

Darkly staining

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8
Q

What do the serous cells contain?

A

Digestive enzymes:

- Including amylase

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9
Q

How does the mucinous component stain?

A

Clear grey

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10
Q

Where do the myoepithelial cells lie in a salivary gland? How do they appear and what properties do they have?

A

Peripherally
Flat/Cuboidal with clear cytoplasm
Some contractile properties

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11
Q

What is a chronic cause of otitis media?

A

Pseudomonas aeruginosa

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12
Q

Where do cholesteatomas typically lie?

A

Superoposterior middle ear

Petrous apex

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13
Q

What is the pathogenesis of cholesteatomas?

A

Chronic otitis media

Perforated tympanic membrane

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14
Q

What is the pathology of a cholesteatoma?

A

Abnormally situated squamous epithelium
High cell turnover
Abundant keratin production
Inflammation

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15
Q

Where are vestibular schwannomas found?

A

Within temporal bone

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16
Q

What percentage of cerebellopontine angle tumours are vestibular schwannomas?

A

80-90%

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17
Q

If there are bilateral vestibular schwannomas in a young patient what should be considered?

A

Neurofibromatosis Type 2

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18
Q

What does NF1 gene do?

A

Encodes neurofibromin at 17q11.2

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19
Q

What is the incidence of NF1?

A

1:3000

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20
Q

Which of the following is not a feature of NF1:

  • Autosomal recessive
  • Widespread neurofibromas
  • Bony defects
  • Cafe au lait spots
  • Axillary freckles
  • Lisch nodules
A

Autosomal recessive (it is Dominant)

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21
Q

What does the NF2 gene do?

A

Encodes merlin protein at 22q12

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22
Q

What is the mode of inheritance of NF2 and what is its incidence?

A

Autosomal dominant:

 - Usually sporadic 1: 40000
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23
Q

What are the features of NF2?

Study These Flashcards
A

Bilateral vestibular schwannomas
Multiple meningiomas
Gliomas
Cafe au lait spots

24
Q

Who are nasal polyps more common in; Women or Men?

25
What are some causes of nasal polyps?
``` Allergy Infection Asthma Aspirin sensitivity Nickel exposure ```
26
What is Samter's Triad?
Asthma Aspirin sensitivity Nasal polyps
27
If a patient presents with nasal polyps and they are a child what should you consider?
CF
28
What is Wegener's Granulomatosis (GPA)?
Small vessel vasculitis: - Respiratory tract - Kidneys
29
Who is GPA more common in?
White patients | Age >40years
30
Which of the following is not a typical presenting feature of GPA: - Pulmonary/Renal disease - Nasal congestion - Hearing loss - 'Coin lesions' - Jaw claudication
Jaw cladication | GCA
31
Where is the incidence of nasopharyngeal cancer increased?
Far East
32
What is nasopharyngeal cancer associated with?
Males EBV Volatile nitrosamines in food
33
What cancers is EBV associated with?
Burkitt's Lymphoma Other B-cell lymphomas Hodgkin's lymphoma
34
Where does EBV infect?
Epithelial cells of oropharynx | B-cells
35
How does EBV affect B-cells?
Hi-jacks and mimics Th-cell responses: | -> Affects B-cell proliferation and survival
36
What is the pathogenesis of the effect EBV has on B-cells?
Mediated by latent membrane protein 1 Encodes EBNA-2 Cyclin D activated G0 to G1 transition promoted
37
What causes laryngeal polyps?
Vocal abuse Infection Smoking Hypothyroidism
38
Who presents with laryngeal nodules? How do they present?
Young women Bilateral Middle third to posterior third on vocal cords
39
How do laryngeal polyps present?
Unilateral | Pedunculated
40
What are the two peak ages for squamous papillomas/papillomatosis?
Kids younger than 5 years | 20-40 years
41
What is squamous papilloma related to?
HPV 6 and 11
42
In which individuals is squamous papilloma aggressive?
Children
43
Where are non-cromaffin positive paragangliomas often found?
Carotid bodies Aortic bodies Jugulotympanic ganglia Ganglia nodosum of vagus nerve
44
What condition do paragangliomas occur as part of?
Multiple Endocrine Neoplasia 2: - Autosomal dominant - Usually multple - Increased malignant transformation
45
How can HPV-16 result in squamous cell carcinoma in the oropharynx?
Produces proteins E6 and E7: - > Disrupts p53 and RB pathways respectively - > Cell immortality
46
What does paramyxovirus cause when it infects the salivary glands?
Mumps: - Bilateral parotitis - Associated orchitis - Risk of secondary meningitis
47
What salivary gland is most likely to have a tumour?
Parotid
48
Which salivary glands have an increased chance of tumour malignant transformation?
Smaller glands
49
If a salivary gland is painful in a young patient what should be suspected?
Malignancy
50
What is the most common salivary gland tumour and who/how does it present in?
Pleomorphic adenoma: - Usually females >60 years - Parotid - Long history
51
Which of the following is not a feature of a Warthin's Tumour: - 3rd most common benign tumour - Rare outwith parotid - Associated with smoking - Males >50 years - Often bilateral and multicentric
3rd most common (it is actually the second most common)
52
What is the most common malignant tumour worldwide in the oropharynx?
Mucoepidermoid carcinoma
53
What is the most common malignant tumour in the UK in the palate?
Adenoid cystic carcinoma
54
What people usually suffer from an Adenoid cystic carcinoma? Where is it typically found?
>40 year olds | Parotid
55
How does a Adenoid cystic carcinoma present if it invades the perineural supply?
Pain | Loss of function

Year 2 - ENT (DP) (11 decks)

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