Pathology

Question 1

what glands are in the auditory meatus and external canal

Answer 1

sebaceous and ceruminous glands

Question 2

what lines the middle ear

Answer 2

columnar epithelium lined mucosa

Question 3

what lines the eustachian tube

Answer 3

respiratory epithelium

Question 4

what gland produce cerumen (ear wax)

Answer 4

ceruminonus glands

Question 5

what lines the nasal vestibule

Answer 5

squamous epithelium (keratinised)

Question 6

what lines the rest of the nose and nasal sinus (apart from the nasal vestibule- most anterior part of nose)

Answer 6

respiratory epithelium with sero negative glands

Question 7

what is respiratory epithelium

Answer 7

pseudostratified ciliated columnar epithelium (with goblet cells)

Question 8

what type of epithelium lines the throat

Answer 8

depends on site:

• oropharynx stratified squamous
• everywhere else respiratory

Question 9

what makes up the oropharynx

Answer 9

tongue from the circumvallate papillae, posteriorly to the epiglottis, the tonsils, the associated pharyngeal walls, and the soft palate

Question 10

what type of gland is the salivary gland

Answer 10

exocrine

Question 11

describe the components of the salivary gland

Answer 11

acinar and ductular component
serous cells
mucinous component
peripheral myoepthelial cells

Question 12

what organisms cause chronic otitis media

Answer 12

Pseudomonas Aeruginosa
Staph aureus
fungal

Question 13

what would you worry about if there was chronic otitis media infection

Answer 13

a tumour

Question 14

what are the complications of otitis media

Answer 14

can perforate tympanic membrane or spread to e.g. mastoid

Question 15

what is a cholesteatoma

Answer 15

not a tumour
lesion made of keratin in the middle ear caused by inflammation (chronic otitis media and perforated tympanic membrane) creating high cell turnover
can erode surrounding structures so need to be removed

Question 16

what is the normal lining of the middle ear

Answer 16

cuboidal or columnar glandular epithelium

Question 17

what is a vestibular schwannoma

Answer 17

an acoustic neuroma

most common tumour of the temporal bone

Question 18

what are the symptoms of a vestibular schwannoma

Answer 18

hearing loss, tinitis, loss of balance, headaches, can grow and compress brain, brain stem

Question 19

what nerve are vestibular schwannomas associated with

Answer 19

vestibular portion of the CN VIII

Question 20

what should you suspect in young patients with bilateral vestibular schwannomas

Answer 20

neurofibromatosis type 2

Question 21

what do vestibular schwannomas look like

Answer 21

will circumscribed, white/tan/yellow mass

Question 22

what are the features of neurofibromatosis type 2

Answer 22

autosomal dominant 
mutation in tumour suppressor gene 
neurofibromas 
bilateral vestibular schwannomas
multiple meningiomas 
gliomas 
cafe au lait spots 
cataracts

Question 23

what are the causes of rhinitis and sinusitis

Answer 23

infections- cold, viral, bacterial

allergy- hay fever

Question 24

who gets nasal polyps

Answer 24

not children

equal in both genders

Question 25

what can cause nasal polyps

Answer 25

allergy, infection, asthma, aspirin sensitivity, nickle exposure

Question 26

what should you consider in a young patient with nasal polyps

Answer 26

cystic firbosis

Question 27

what is granulomatosis with polyangitis

Answer 27

autoimmune disorder small vessel vasculitis and necrosis usually limited to the respiratory tracts and kidneys

Question 28

how dors granulomatosis with polyangitis present

Answer 28

pulmonary, renal disease (haematuria, glomerulonephritis, hypertension), nasal symptoms (congestion, septal perforation)

Question 29

what is in high levels in GPA

Answer 29

ANCA +ve | multinucleated giant cells

Question 30

what is cANCA associated with

Answer 30

GPA

Question 31

what is pANCA associated with

Answer 31

microscopic polyangitis

Question 32

what is the most common malignant tumour of the nose

Answer 32

squamous cell carcinoma can also get adenocarcinomas, nasopharyngeal carcinomas, neuroblastomas, lymphomas

Question 33

what benign tumours do you get in the nose

Answer 33

squamous papillomas, scheiderian papillomas, angiofibromas

Question 34

what is a schneiderian papilloma

Answer 34

benign nasal tumour patients over 50, more common in males presents with a blocked nose

Question 35

what are the causes of a schneiderian papilloma

Answer 35

HPV, smoking, organic solvents, welding

Question 36

what are the types of schneiderian papilloma

Answer 36

inverted and oncocytic (on lateral walls and paranasal sinuses) exophytic (nasal septum)

Question 37

what does a nasopharyngeal carcinoma have a strong association with

Answer 37

esptein barr virus + volatile nitrosamines in food occupation and family history

Question 38

what are the types of nasopharyngeal carcinoma

Answer 38

keratinising SCC or non keratinising

Question 39

how does epstein barr virus cause carcinogenesis

Answer 39

hi-jacks and mimicks helper T-cell responses leading to proliferation and survival of B-cells

Question 40

what are laryngeal polyps

Answer 40

Reactive change in laryngeal mucosa secondary to - vocal abuse, infection and smoking. Occ. in hypothyroidism (due to oedema build up).

Question 41

what is a contact ulcer

Answer 41

benign response to injury | e,g, chronic throat clearing, voice abuse, GORD, intubation

Question 42

who gets squamous papiloma/papillomatosis

Answer 42

<5 years and between 20-40 years related to HPV exposure

Question 43

what is a paraganglioma

Answer 43

Tumours arrising in clusters of neuroendocrine cells | can be chromaffin positive or negative

Question 44

what are squamous cell carcinomas in the head and neck associated with

Answer 44

smoking, alcohol, HPV

Question 45

how do you diagnose SCC

Answer 45

need to see keratinisation and pickle cells on biopsy

Question 46

what are sialolithiasis

Answer 46

stones of the salivary glands

Question 47

what infections can you get in the salivary glands

Answer 47

paramyxovirus (mumps)

Question 48

where is the most common site for all salivary gland tumours

Answer 48

parotid

Question 49

what salivary gland tumours are more likely to be malignant

Answer 49

those in the smaller glands

Question 50

what should a young patient with a painful salivary gland mass make you think

Answer 50

malignancy

Question 51

what is a pleomorphic tumour

Answer 51

most common salivary gland tumour- risk of malignant transformation, usually in parotid

Question 52

what is a warthins tumour

Answer 52

benign tumour of the salivary glands associated with smoking

Question 53

what is the most common malignant tumour of the salivary glands

Answer 53

adenoid cystic carcinoma | outside of uk most common mucoepidermoid carcinoma

Question 54

what is an adenoid cystic

Answer 54

most common malignant tumour of the palate

Question 55

what is the histology of nasal polyps like

Answer 55

resp epithelium on surface | lots of inflammatory cells inside

Question 56

what is aspergillis

Answer 56

a ball of fungus found in a single lung cavity - which may improve or disappear, or change very little over a few years. Chronic cavitary pulmonary aspergillosis (CCPA) where cavities are present in the lungs, but not necessarily with a fungal ball (aspergilloma)

Question 57

what tumours are associated with ebstein barre virus

Answer 57

Burkitt's lymphoma. B-cell lymphoproliferative syndromes, and nasopharyngeal carcinoma with Hodgkin's disease, T-cell lymphomas, and gastric carcinoma, as well as being the causal agent for infectious mononucleosis.

Question 58

what is a histiocyte

Answer 58

a stationary phagocytic cell present in connective tissue

Question 59

what covers the vocal chords

Answer 59

stratified squamous epithelium

Question 60

what virus is squamous cell carcinoma associated with

Answer 60

HPV types 6 and 11

Question 61

what do paragangliomas look like

Answer 61

nested appearance

Question 62

what do parotid glands look like histologcally

Answer 62

very serous