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414 Cards in this Set
- Front
- Back
|
Cattarrhal discharge
Secondary bacterial infections Common Cold by viruses |
Infective Rhinitis
|
|
|
Allergic Reaction
Hay Fever 20% of the population Type 1 hypersensitivity |
Allergic Rhinitis
|
|
|
What are the main cells and Ig found in an allergic type 1 reaction ?
|
IgE
Eosinophils |
|
|
who is gay
|
me
|
|
|
Cattarrhal Discharge
Secondary bacterial Common cold by viruses |
Infective Rhinitis
|
|
|
Allergic Reaction
Hay Fever 20% of the population Type 1 hypersensitivity |
Allergic Rhinitis
|
|
|
Cattarrhal Discharge
Secondary bacterial Common cold by viruses |
Infective Rhinitis
|
|
|
Allergic Reaction
Hay Fever 20% of the population Type 1 hypersensitivity |
Allergic Rhinitis
|
|
|
32 y/o female nasal congestion
Nasal Speculum exam Has ↑ Eosinophils and preserved epithelial layers surgical removal |
Nasal Polyps
|
|
|
Encroach on the airway
Impair sinus drainage Most patients are not atopic!!! |
Nasal Polyps
|
|
|
44 y/o female with facial pain
Low grade fever CT ordered MCC bacterial & In diabetics - fungal (Mucor) |
Sinusitis
|
|
|
Immotile Cilia
Infertility Sitis Invertus |
Kartageners Syndrome
Chronic Sinusitis |
|
|
Cattarrhal Discharge
Secondary bacterial Common cold by viruses |
Infective Rhinitis
|
|
|
Allergic Reaction
Hay Fever 20% of the population Type 1 hypersensitivity |
Allergic Rhinitis
|
|
|
32 y/o female nasal congestion
Nasal Speculum exam Has ↑ Eosinophils and preserved epithelial layers surgical removal |
Nasal Polyps
|
|
|
Encroach on the airway
Impair sinus drainage Most patients are not atopic!!! |
Nasal Polyps
|
|
|
44 y/o female with facial pain
Low grade fever CT ordered MCC bacterial & In diabetics - fungal (Mucor) |
Sinusitis
|
|
|
Immotile Cilia
Infertility Sitis Invertus |
Kartageners Syndrome
Chronic Sinusitis |
|
|
Aspergillus Fumigatus
|
Acute and Chronic Sinusitis
|
|
|
51 y/o male with fever and myalgias
Nasal Bx Lab test positive for c-ANCA Necrotizing Vasculitis |
Wegners Syndrome
|
|
|
What is seen in a lung biopsy of a Wegners patient
|
Blood vessels surrounded by neutrophils
|
|
|
Pseudomembrane in the posterior pharynx
Can obstruct the airways |
Diptheria
|
|
|
17 y/o female with sore throat
Exam erythematous pharynx grows beta hemolytic streptococci |
Strep. Throat
|
|
|
What kind of hemolysis do you see in strep throat
|
Beta Hemolysis
|
|
|
What causes Rhinoscleroma
|
Klebsiella
|
|
|
Most common post strep infection
|
Glomerulonephritis
|
|
|
Chronic infections of the nasopharynx
Follicular Hyperplasia |
Chronic Tonsilitis
|
|
|
23 y/o female with nasal congestion
Exam shows narrowed left airway Exploratory surgery performed |
Inverted Papilloma
"Schneiderian" |
|
|
Highly vascular unencapsulated tumor, seen in adolescent males, present as epistaxis, biopsy is contra - indicated
|
Nasopharyngeal Angiofibroma
|
|
|
HPV associated
Proliferation of epithelial tissue, in nose, throat, mouth |
Papilloma
|
|
|
Extends into mucosa NOT exophytic growth (inverted)
Benign tumor but Locally aggressive (high recurrence rate) Rare progression to carcinoma |
Inverted Papilloma
"Schneiderian" |
|
|
Arising from neural crest cells
Highly malignant, metastasize widely Positive for NSE (Neuron-specific enolase) & S-100 (immuno stain), t(11:22) absent, has Pseudo- rosettes Small round blue cell tumors |
Olfactory Neuroblastoma
|
|
|
Sinuses
Malignant plasma cell tumor |
Plasmacytomas
|
|
|
12 y/o child with dysphagia
Exam large pharyngeal mass Mono spot ordered! Tumor associated with EBV Very rare in the US |
Nasopharyngeal Carcinoma
|
|
|
Subtypes of Nasopharyngeal Carcinoma
|
Keratinizing
Nonkeratinizing Undifferentiated Lymphoepithelioma |
|
|
Cattarrhal Discharge
Secondary bacterial Common cold by viruses |
Infective Rhinitis
|
|
|
Allergic Reaction
Hay Fever 20% of the population Type 1 hypersensitivity |
Allergic Rhinitis
|
|
|
32 y/o female nasal congestion
Nasal Speculum exam Has ↑ Eosinophils and preserved epithelial layers surgical removal |
Nasal Polyps
|
|
|
Encroach on the airway
Impair sinus drainage Most patients are not atopic!!! |
Nasal Polyps
|
|
|
44 y/o female with facial pain
Low grade fever CT ordered MCC bacterial & In diabetics - fungal (Mucor) |
Sinusitis
|
|
|
Immotile Cilia
Infertility Sitis Invertus |
Kartageners Syndrome
Chronic Sinusitis |
|
|
Aspergillus Fumigatus
|
Acute and Chronic Sinusitis
|
|
|
51 y/o male with fever and myalgias
Nasal Bx Lab test positive for c-ANCA Necrotizing Vasculitis |
Wegners Syndrome
|
|
|
What is seen in a lung biopsy of a Wegners patient
|
Blood vessels surrounded by neutrophils
|
|
|
Pseudomembrane in the posterior pharynx
Can obstruct the airways |
Diptheria
|
|
|
17 y/o female with sore throat
Exam erythematous pharynx grows beta hemolytic streptococci |
Strep. Throat
|
|
|
What kind of hemolysis do you see in strep throat
|
Beta Hemolysis
|
|
|
What causes Rhinoscleroma
|
Klebsiella
|
|
|
Most common post strep infection
|
Glomerulonephritis
|
|
|
Chronic infections of the nasopharynx
Follicular Hyperplasia |
Chronic Tonsilitis
|
|
|
23 y/o female with nasal congestion
Exam shows narrowed left airway Exploratory surgery performed |
Inverted Papilloma
"Schneiderian" |
|
|
Highly vascular unencapsulated tumor, seen in adolescent males, present as epistaxis, biopsy is contra - indicated
|
Nasopharyngeal Angiofibroma
|
|
|
HPV associated
Proliferation of epithelial tissue, in nose, throat, mouth |
Papilloma
|
|
|
Extends into mucosa NOT exophytic growth (inverted)
Benign tumor but Locally aggressive (high recurrence rate) Rare progression to carcinoma |
Inverted Papilloma
"Schneiderian" |
|
|
Arising from neural crest cells
Highly malignant, metastasize widely Positive for NSE (Neuron-specific enolase) & S-100 (immuno stain), t(11:22) absent, has Pseudo- rosettes Small round blue cell tumors |
Olfactory Neuroblastoma
|
|
|
Sinuses
Malignant plasma cell tumor |
Plasmacytomas
|
|
|
12 y/o child with dysphagia
Exam large pharyngeal mass Mono spot ordered! Tumor associated with EBV Very rare in the US |
Nasopharyngeal Carcinoma
|
|
|
Subtypes of Nasopharyngeal Carcinoma
|
Keratinizing
Nonkeratinizing Undifferentiated Lymphoepithelioma |
|
|
Upper respiratory infection that is caused mainly by tobacco smoke
|
Laryngitis
|
|
|
What are the causes of laryngitis in children
|
Stridor due to narrowing of the airways
|
|
|
Effects of laryngitis on young infants
|
Laryngeal Edema
Obstruction and death |
|
|
Causes of croup in children
|
Laryngotracheobronchitis
|
|
|
Small lesions found on both sides of the vocal cords
Cause hoarseness of voice Never give rise to cancer |
Singer's Nodes
(Laryngeal Nodules) |
|
|
54 y/o male with hoarseness
Smokes 2 ppd Noticed a lump in his neck! Lymph node metastasis |
Squamous Cell Carcinoma
|
|
|
What is a sequence of the development of a cancer
|
Hyperplasia
Dysplasia Carcinoma |
|
|
Risk factors for SSC
|
Tobacco
Alcohol HPV |
|
|
Benign Lesions
1cm or less HPV 6 and 11 |
Papilloma
|
|
|
Related to HPV infection and form Koliocytes which show a perinuclear halo
|
Papilloma
|
|
|
Cattarrhal Discharge
Secondary bacterial Common cold by viruses |
Infective Rhinitis
|
|
|
Allergic Reaction
Hay Fever 20% of the population Type 1 hypersensitivity |
Allergic Rhinitis
|
|
|
32 y/o female nasal congestion
Nasal Speculum exam Has ↑ Eosinophils and preserved epithelial layers surgical removal |
Nasal Polyps
|
|
|
Encroach on the airway
Impair sinus drainage Most patients are not atopic!!! |
Nasal Polyps
|
|
|
44 y/o female with facial pain
Low grade fever CT ordered MCC bacterial & In diabetics - fungal (Mucor) |
Sinusitis
|
|
|
Immotile Cilia
Infertility Sitis Invertus |
Kartageners Syndrome
Chronic Sinusitis |
|
|
Aspergillus Fumigatus
|
Acute and Chronic Sinusitis
|
|
|
51 y/o male with fever and myalgias
Nasal Bx Lab test positive for c-ANCA Necrotizing Vasculitis |
Wegners Syndrome
|
|
|
What is seen in a lung biopsy of a Wegners patient
|
Blood vessels surrounded by neutrophils
|
|
|
Pseudomembrane in the posterior pharynx
Can obstruct the airways |
Diptheria
|
|
|
17 y/o female with sore throat
Exam erythematous pharynx grows beta hemolytic streptococci |
Strep. Throat
|
|
|
What kind of hemolysis do you see in strep throat
|
Beta Hemolysis
|
|
|
What causes Rhinoscleroma
|
Klebsiella
|
|
|
Most common post strep infection
|
Glomerulonephritis
|
|
|
Chronic infections of the nasopharynx
Follicular Hyperplasia |
Chronic Tonsilitis
|
|
|
23 y/o female with nasal congestion
Exam shows narrowed left airway Exploratory surgery performed |
Inverted Papilloma
"Schneiderian" |
|
|
Highly vascular unencapsulated tumor, seen in adolescent males, present as epistaxis, biopsy is contra - indicated
|
Nasopharyngeal Angiofibroma
|
|
|
HPV associated
Proliferation of epithelial tissue, in nose, throat, mouth |
Papilloma
|
|
|
Extends into mucosa NOT exophytic growth (inverted)
Benign tumor but Locally aggressive (high recurrence rate) Rare progression to carcinoma |
Inverted Papilloma
"Schneiderian" |
|
|
Arising from neural crest cells
Highly malignant, metastasize widely Positive for NSE (Neuron-specific enolase) & S-100 (immuno stain), t(11:22) absent, has Pseudo- rosettes Small round blue cell tumors |
Olfactory Neuroblastoma
|
|
|
Sinuses
Malignant plasma cell tumor |
Plasmacytomas
|
|
|
12 y/o child with dysphagia
Exam large pharyngeal mass Mono spot ordered! Tumor associated with EBV Very rare in the US |
Nasopharyngeal Carcinoma
|
|
|
Subtypes of Nasopharyngeal Carcinoma
|
Keratinizing
Nonkeratinizing Undifferentiated Lymphoepithelioma |
|
|
Upper respiratory infection that is caused mainly by tobacco smoke
|
Laryngitis
|
|
|
What are the causes of laryngitis in children
|
Stridor due to narrowing of the airways
|
|
|
Effects of laryngitis on young infants
|
Laryngeal Edema
Obstruction and death |
|
|
Causes of croup in children
|
Laryngotracheobronchitis
|
|
|
Small lesions found on both sides of the vocal cords
Cause hoarseness of voice Never give rise to cancer |
Singer's Nodes
(Laryngeal Nodules) |
|
|
54 y/o male with hoarseness
Smokes 2 ppd Noticed a lump in his neck! Lymph node metastasis |
Squamous Cell Carcinoma
|
|
|
What is a sequence of the development of a cancer
|
Hyperplasia
Dysplasia Carcinoma |
|
|
Risk factors for SSC
|
Tobacco
Alcohol HPV |
|
|
Benign Lesions
1cm or less HPV 6 and 11 |
Papilloma
|
|
|
Related to HPV infection and form Koliocytes which show a perinuclear halo
|
Papilloma
|
|
|
Bacteria that cause Acute Otitis Media
|
Streptococcus
H.influenzea Moraxella |
|
|
Causes for Chronic Otitis Media
|
Pseudomonas
Staphylococcus Fungal |
|
|
Perforation
Mastoiditis Mengitis |
Chronic Otitis Media
|
|
|
Cholesteatoma
|
Chronic Otitis Media
|
|
|
Cholesterol Clefts with keratinous squamous epithelium
Granulomatous and behaves like tumor |
Cholesteatoma found in Chronic Otitis Media
|
|
|
Abnormal bone deposition of stapes
Bilateral and familial AD |
Otosclerosis
|
|
|
Tumors of the External Ear
|
Squamous
Basel Melanoma |
|
|
Tumors of Middle Ear
|
Anything goes
|
|
|
Cyst found at anterolateral neck ,Lined by stratified squamous or pseudostratified columnar epithelium,contain abundant lymphoid tissue
|
Branchial Cyst
|
|
|
Cyst Found anteriorly, midline, due to the remnants of thyroid developmental tract that persists producing cyst
|
Thyroglossal Duct Cyst
|
|
|
34 y/o female with a mass in her lateral neck
Exam - soft and cystic Ultrasound confirms cyst |
Branchial Cyst
|
|
|
35 y/o female with mass in medial neck
Exam soft Ultrasound cystic |
Thyroglossal Duct Cyst
|
|
|
62 y/o male with Hypertension
Dizziness and vertigo Dx - Carotid insufficiency Mass found arising from the carotid Blood pressure changes |
Paraganglioma
|
|
|
composed of nests (zellballen) of polygonal chief cells enclosed by trabeculae of fibrous and sustentacular elongated cells
|
Paraganglioma
|
|
|
Neuroendocrine markers :nonspecific enolase (NSE), S-100, chromogranin are positive
|
Paraganglioma
|
|
|
Derived from neuroendocrine cells (in adrenal medulla called –Pheochromocytomas)
|
Paraganglioma
|
|
|
Paravertebral
Sympathetic Chromaffin positive Elaborate catecholamines |
Paraganglioma
|
|
|
chromaffin body derived from neural crest located at the bifurcation of the aorta or at the origin of the inferior mesenteric artery. It can be the source of pheochromocytoma
|
Organ of Zukerkandl
|
|
|
Pheochromcytoma
Parathyroid Pituitary |
MEN 2
|
|
|
Cattarrhal Discharge
Secondary bacterial Common cold by viruses |
Infective Rhinitis
|
|
|
Allergic Reaction
Hay Fever 20% of the population Type 1 hypersensitivity |
Allergic Rhinitis
|
|
|
32 y/o female nasal congestion
Nasal Speculum exam Has ↑ Eosinophils and preserved epithelial layers surgical removal |
Nasal Polyps
|
|
|
Encroach on the airway
Impair sinus drainage Most patients are not atopic!!! |
Nasal Polyps
|
|
|
44 y/o female with facial pain
Low grade fever CT ordered MCC bacterial & In diabetics - fungal (Mucor) |
Sinusitis
|
|
|
Immotile Cilia
Infertility Sitis Invertus |
Kartageners Syndrome
Chronic Sinusitis |
|
|
Aspergillus Fumigatus
|
Acute and Chronic Sinusitis
|
|
|
51 y/o male with fever and myalgias
Nasal Bx Lab test positive for c-ANCA Necrotizing Vasculitis |
Wegners Syndrome
|
|
|
What is seen in a lung biopsy of a Wegners patient
|
Blood vessels surrounded by neutrophils
|
|
|
Pseudomembrane in the posterior pharynx
Can obstruct the airways |
Diptheria
|
|
|
17 y/o female with sore throat
Exam erythematous pharynx grows beta hemolytic streptococci |
Strep. Throat
|
|
|
What kind of hemolysis do you see in strep throat
|
Beta Hemolysis
|
|
|
What causes Rhinoscleroma
|
Klebsiella
|
|
|
Most common post strep infection
|
Glomerulonephritis
|
|
|
Chronic infections of the nasopharynx
Follicular Hyperplasia |
Chronic Tonsilitis
|
|
|
23 y/o female with nasal congestion
Exam shows narrowed left airway Exploratory surgery performed |
Inverted Papilloma
"Schneiderian" |
|
|
Highly vascular unencapsulated tumor, seen in adolescent males, present as epistaxis, biopsy is contra - indicated
|
Nasopharyngeal Angiofibroma
|
|
|
HPV associated
Proliferation of epithelial tissue, in nose, throat, mouth |
Papilloma
|
|
|
Extends into mucosa NOT exophytic growth (inverted)
Benign tumor but Locally aggressive (high recurrence rate) Rare progression to carcinoma |
Inverted Papilloma
"Schneiderian" |
|
|
Arising from neural crest cells
Highly malignant, metastasize widely Positive for NSE (Neuron-specific enolase) & S-100 (immuno stain), t(11:22) absent, has Pseudo- rosettes Small round blue cell tumors |
Olfactory Neuroblastoma
|
|
|
Sinuses
Malignant plasma cell tumor |
Plasmacytomas
|
|
|
12 y/o child with dysphagia
Exam large pharyngeal mass Mono spot ordered! Tumor associated with EBV Very rare in the US |
Nasopharyngeal Carcinoma
|
|
|
Subtypes of Nasopharyngeal Carcinoma
|
Keratinizing
Nonkeratinizing Undifferentiated Lymphoepithelioma |
|
|
Upper respiratory infection that is caused mainly by tobacco smoke
|
Laryngitis
|
|
|
What are the causes of laryngitis in children
|
Stridor due to narrowing of the airways
|
|
|
Effects of laryngitis on young infants
|
Laryngeal Edema
Obstruction and death |
|
|
Causes of croup in children
|
Laryngotracheobronchitis
|
|
|
Small lesions found on both sides of the vocal cords
Cause hoarseness of voice Never give rise to cancer |
Singer's Nodes
(Laryngeal Nodules) |
|
|
54 y/o male with hoarseness
Smokes 2 ppd Noticed a lump in his neck! Lymph node metastasis |
Squamous Cell Carcinoma
|
|
|
What is a sequence of the development of a cancer
|
Hyperplasia
Dysplasia Carcinoma |
|
|
Risk factors for SSC
|
Tobacco
Alcohol HPV |
|
|
Benign Lesions
1cm or less HPV 6 and 11 |
Papilloma
|
|
|
Related to HPV infection and form Koliocytes which show a perinuclear halo
|
Papilloma
|
|
|
Bacteria that cause Acute Otitis Media
|
Streptococcus
H.influenzea Moraxella |
|
|
Causes for Chronic Otitis Media
|
Pseudomonas
Staphylococcus Fungal |
|
|
Perforation
Mastoiditis Mengitis |
Chronic Otitis Media
|
|
|
Cholesteatoma
|
Chronic Otitis Media
|
|
|
Cholesterol Clefts with keratinous squamous epithelium
Granulomatous and behaves like tumor |
Cholesteatoma found in Chronic Otitis Media
|
|
|
Abnormal bone deposition of stapes
Bilateral and familial AD |
Otosclerosis
|
|
|
Tumors of the External Ear
|
Squamous
Basel Melanoma |
|
|
Tumors of Middle Ear
|
Anything goes
|
|
|
Cyst found at anterolateral neck ,Lined by stratified squamous or pseudostratified columnar epithelium,contain abundant lymphoid tissue
|
Branchial Cyst
|
|
|
Cyst Found anteriorly, midline, due to the remnants of thyroid developmental tract that persists producing cyst
|
Thyroglossal Duct Cyst
|
|
|
34 y/o female with a mass in her lateral neck
Exam - soft and cystic Ultrasound confirms cyst |
Branchial Cyst
|
|
|
35 y/o female with mass in medial neck
Exam soft Ultrasound cystic |
Thyroglossal Duct Cyst
|
|
|
62 y/o male with Hypertension
Dizziness and vertigo Dx - Carotid insufficiency Mass found arising from the carotid Blood pressure changes |
Paraganglioma
|
|
|
composed of nests (zellballen) of polygonal chief cells enclosed by trabeculae of fibrous and sustentacular elongated cells
|
Paraganglioma
|
|
|
Neuroendocrine markers :nonspecific enolase (NSE), S-100, chromogranin are positive
|
Paraganglioma
|
|
|
Derived from neuroendocrine cells (in adrenal medulla called –Pheochromocytomas)
|
Paraganglioma
|
|
|
Paravertebral
Sympathetic Chromaffin positive Elaborate catecholamines |
Paraganglioma
|
|
|
chromaffin body derived from neural crest located at the bifurcation of the aorta or at the origin of the inferior mesenteric artery. It can be the source of pheochromocytoma
|
Organ of Zukerkandl
|
|
|
Pheochromcytoma
Parathyroid Pituitary |
MEN 2
|
|
|
Cattarrhal Discharge
Secondary bacterial Common cold by viruses |
Infective Rhinitis
|
|
|
Allergic Reaction
Hay Fever 20% of the population Type 1 hypersensitivity |
Allergic Rhinitis
|
|
|
32 y/o female nasal congestion
Nasal Speculum exam Has ↑ Eosinophils and preserved epithelial layers surgical removal |
Nasal Polyps
|
|
|
Encroach on the airway
Impair sinus drainage Most patients are not atopic!!! |
Nasal Polyps
|
|
|
44 y/o female with facial pain
Low grade fever CT ordered MCC bacterial & In diabetics - fungal (Mucor) |
Sinusitis
|
|
|
Immotile Cilia
Infertility Sitis Invertus |
Kartageners Syndrome
Chronic Sinusitis |
|
|
Aspergillus Fumigatus
|
Acute and Chronic Sinusitis
|
|
|
51 y/o male with fever and myalgias
Nasal Bx Lab test positive for c-ANCA Necrotizing Vasculitis |
Wegners Syndrome
|
|
|
What is seen in a lung biopsy of a Wegners patient
|
Blood vessels surrounded by neutrophils
|
|
|
Pseudomembrane in the posterior pharynx
Can obstruct the airways |
Diptheria
|
|
|
17 y/o female with sore throat
Exam erythematous pharynx grows beta hemolytic streptococci |
Strep. Throat
|
|
|
What kind of hemolysis do you see in strep throat
|
Beta Hemolysis
|
|
|
What causes Rhinoscleroma
|
Klebsiella
|
|
|
Most common post strep infection
|
Glomerulonephritis
|
|
|
Chronic infections of the nasopharynx
Follicular Hyperplasia |
Chronic Tonsilitis
|
|
|
23 y/o female with nasal congestion
Exam shows narrowed left airway Exploratory surgery performed |
Inverted Papilloma
"Schneiderian" |
|
|
Highly vascular unencapsulated tumor, seen in adolescent males, present as epistaxis, biopsy is contra - indicated
|
Nasopharyngeal Angiofibroma
|
|
|
HPV associated
Proliferation of epithelial tissue, in nose, throat, mouth |
Papilloma
|
|
|
Extends into mucosa NOT exophytic growth (inverted)
Benign tumor but Locally aggressive (high recurrence rate) Rare progression to carcinoma |
Inverted Papilloma
"Schneiderian" |
|
|
Arising from neural crest cells
Highly malignant, metastasize widely Positive for NSE (Neuron-specific enolase) & S-100 (immuno stain), t(11:22) absent, has Pseudo- rosettes Small round blue cell tumors |
Olfactory Neuroblastoma
|
|
|
Sinuses
Malignant plasma cell tumor |
Plasmacytomas
|
|
|
12 y/o child with dysphagia
Exam large pharyngeal mass Mono spot ordered! Tumor associated with EBV Very rare in the US |
Nasopharyngeal Carcinoma
|
|
|
Subtypes of Nasopharyngeal Carcinoma
|
Keratinizing
Nonkeratinizing Undifferentiated Lymphoepithelioma |
|
|
Upper respiratory infection that is caused mainly by tobacco smoke
|
Laryngitis
|
|
|
What are the causes of laryngitis in children
|
Stridor due to narrowing of the airways
|
|
|
Effects of laryngitis on young infants
|
Laryngeal Edema
Obstruction and death |
|
|
Causes of croup in children
|
Laryngotracheobronchitis
|
|
|
Small lesions found on both sides of the vocal cords
Cause hoarseness of voice Never give rise to cancer |
Singer's Nodes
(Laryngeal Nodules) |
|
|
54 y/o male with hoarseness
Smokes 2 ppd Noticed a lump in his neck! Lymph node metastasis |
Squamous Cell Carcinoma
|
|
|
What is a sequence of the development of a cancer
|
Hyperplasia
Dysplasia Carcinoma |
|
|
Risk factors for SSC
|
Tobacco
Alcohol HPV |
|
|
Benign Lesions
1cm or less HPV 6 and 11 |
Papilloma
|
|
|
Related to HPV infection and form Koliocytes which show a perinuclear halo
|
Papilloma
|
|
|
Bacteria that cause Acute Otitis Media
|
Streptococcus
H.influenzea Moraxella |
|
|
Causes for Chronic Otitis Media
|
Pseudomonas
Staphylococcus Fungal |
|
|
Perforation
Mastoiditis Mengitis |
Chronic Otitis Media
|
|
|
Cholesteatoma
|
Chronic Otitis Media
|
|
|
Cholesterol Clefts with keratinous squamous epithelium
Granulomatous and behaves like tumor |
Cholesteatoma found in Chronic Otitis Media
|
|
|
Abnormal bone deposition of stapes
Bilateral and familial AD |
Otosclerosis
|
|
|
Tumors of the External Ear
|
Squamous
Basel Melanoma |
|
|
Tumors of Middle Ear
|
Anything goes
|
|
|
Cyst found at anterolateral neck ,Lined by stratified squamous or pseudostratified columnar epithelium,contain abundant lymphoid tissue
|
Branchial Cyst
|
|
|
Cyst Found anteriorly, midline, due to the remnants of thyroid developmental tract that persists producing cyst
|
Thyroglossal Duct Cyst
|
|
|
34 y/o female with a mass in her lateral neck
Exam - soft and cystic Ultrasound confirms cyst |
Branchial Cyst
|
|
|
35 y/o female with mass in medial neck
Exam soft Ultrasound cystic |
Thyroglossal Duct Cyst
|
|
|
62 y/o male with Hypertension
Dizziness and vertigo Dx - Carotid insufficiency Mass found arising from the carotid Blood pressure changes |
Paraganglioma
|
|
|
composed of nests (zellballen) of polygonal chief cells enclosed by trabeculae of fibrous and sustentacular elongated cells
|
Paraganglioma
|
|
|
Neuroendocrine markers :nonspecific enolase (NSE), S-100, chromogranin are positive
|
Paraganglioma
|
|
|
Derived from neuroendocrine cells (in adrenal medulla called –Pheochromocytomas)
|
Paraganglioma
|
|
|
Paravertebral
Sympathetic Chromaffin positive Elaborate catecholamines |
Paraganglioma
|
|
|
chromaffin body derived from neural crest located at the bifurcation of the aorta or at the origin of the inferior mesenteric artery. It can be the source of pheochromocytoma
|
Organ of Zukerkandl
|
|
|
Pheochromcytoma
Parathyroid Pituitary |
MEN 2
|
|
|
Dry mouth
|
Xerostomia
|
|
|
Which is more prone for malignancies Mucous or serous glands
|
Mucous glands
|
|
|
S.aureus and Strep. Viridans
Dehydration Impacted food |
Sialolithiasis
|
|
|
Stones formed and block the gland
|
Sialolithiasis
|
|
|
42 y/o female with dry mouth and eyes
Lab work up done Black dotted cells ANA positive SSa Atrophy of the tongue |
Sjogrens Syndroms
|
|
|
23 y/o male with lip lesion
Most common lesion Blockage or rupture Fluctuate with meals! Ranula - sublingual duct |
Mucocele
|
|
|
Most common Salivary Gland tumor
|
Benign Pleomorphic adenoma
|
|
|
52 y/o female
Mass in her neck Swelling anterior to the ear |
Pleomorphic Adenoma
|
|
|
Swelling in front of and below the ear
5th to 7th decade Slow growing and large |
Pleomorphic Adenoma
|
|
|
What is the most common tumor of the parotid
|
Pleomorphic Adenoma
|
|
|
51 y/o male with lateral neck mass
Exam soft and cystic Both solid and cystic lesions are seen |
Warthin Tumor
Papillary Cystadenoma Lymphomatosum |
|
|
Most common bilateral tumor of the parotid
|
Warthin Tumor
Papillary Cystadenoma Lymphomatosum |
|
|
2% reccurence rates
|
Warthin Tumor
Papillary Cystadenoma Lymphomatosum |
|
|
Most common malignant tumor of the salivary glands
|
Mucoepidermoid Carcinoma
|
|
|
What the chance of recurrance of mucoepidermoid carcinoma
|
Low grade 5 year survival of 90%
High grade 5 year is 50%! |
|
|
65 y/o male with mass
Floor of his mouth Painful-Perinueral invasion |
Adenoid Cystic Carcinoma
|
|
|
Most common rare malignant tumor of the parotid gland
|
Acinic Cell Carcinoma
|
|
|
Most common site for pathology for the upper GI tract
|
Gastroesophageal Junction
(GE junction). |
|
|
Being born and cant feed, hungry and very fussy, and get aspiration pnemonia and abnormal chest xray.
|
Tracheoesophageal fistula
|
|
|
Asthmatic symptoms, particularly nocturnal
Reflux of gastric contents into pharynx |
Regurgitation
|
|
|
Difficulty in transferring food to esophagus or in initiating swallowing
|
Oropharyngeal dysphagia
|
|
|
Difficulty in transporting down esophagus, food “gets stuck”
|
Esophageal dysphagia
|
|
|
Failure of GEJ to relax
|
Achalasia
|
|
|
Back pouching and most common esophageal motor dysfunction
|
Hiatal hernia (95%)
|
|
|
Disease that lives in the ganglion and causes achlasia
|
Chagas disease
|
|
|
Severe retching or violent vomiting
Usually alcoholics 5-10% of UGI bleeds, but usually not profuse Heals promptly |
Mallor-Weiss Laceration
|
|
|
Related to portal hypertension
90% of cirrhotics, usually alcoholics Also, schistosomiasis is causative worldwide Asymptomatic, until rupture causes massive hematemesis 40-50% fatality rate per episode |
Esophageal Varices
|
|
|
Caused by Lye Strictures
Candidiasis HSV and CMV GERD |
Esophagitis
|
|
|
Cowdry type A Inclusions
|
Show replication and HSV presence in Herpes Esophagitis
|
|
|
Heartburn
Regurgitation of gastric contents into pharynx Dysphagia |
GERD
|
|
|
Complication of GERD
|
Esophageal ulceration
Barrett Mucosa (Esophagus) Stricture with stenosis (narrowing) Long-term risk adenocarcinoma |
|
|
Reflux
Dysphagia Eosinophils Atopic |
Eosinophilic Esophagitis
|
|
|
Converstion from Squamous to Glandular mucosa
|
Barrett esophagus
|
|
|
Risk for Adenocarcinoma with 30-40 fold increase if >3 cm
|
Barrett esophagus
|
|
|
Immune disorder that can cause stricture in the esophagus
|
Scleroderma
|
|
|
Barretts esophagus transition
|
Squamous
Metaplasia Dysplasia Carcinoma |
|
|
Middle 1/3 Esophageal Cancer
|
SCC
|
|
|
Lower 1/3 Esophageal Cancer
|
Adenocarcinoma
|
|
|
Can barely eat food and drink most of the time
|
SSC
Mid Esophageal |
|
|
What is the common stage of SSC
|
Stage 4
|
|
|
Which tumor do you see Keratinization Pearls in
|
SSC
Mid Esophageal |
|
|
Most common benign tumor of the esophagus
|
Leiomyoma
|
|
|
Cattarrhal Discharge
Secondary bacterial Common cold by viruses |
Infective Rhinitis
|
|
|
Allergic Reaction
Hay Fever 20% of the population Type 1 hypersensitivity |
Allergic Rhinitis
|
|
|
32 y/o female nasal congestion
Nasal Speculum exam Has ↑ Eosinophils and preserved epithelial layers surgical removal |
Nasal Polyps
|
|
|
Encroach on the airway
Impair sinus drainage Most patients are not atopic!!! |
Nasal Polyps
|
|
|
44 y/o female with facial pain
Low grade fever CT ordered MCC bacterial & In diabetics - fungal (Mucor) |
Sinusitis
|
|
|
Immotile Cilia
Infertility Sitis Invertus |
Kartageners Syndrome
Chronic Sinusitis |
|
|
Aspergillus Fumigatus
|
Acute and Chronic Sinusitis
|
|
|
51 y/o male with fever and myalgias
Nasal Bx Lab test positive for c-ANCA Necrotizing Vasculitis |
Wegners Syndrome
|
|
|
What is seen in a lung biopsy of a Wegners patient
|
Blood vessels surrounded by neutrophils
|
|
|
Pseudomembrane in the posterior pharynx
Can obstruct the airways |
Diptheria
|
|
|
17 y/o female with sore throat
Exam erythematous pharynx grows beta hemolytic streptococci |
Strep. Throat
|
|
|
What kind of hemolysis do you see in strep throat
|
Beta Hemolysis
|
|
|
What causes Rhinoscleroma
|
Klebsiella
|
|
|
Most common post strep infection
|
Glomerulonephritis
|
|
|
Chronic infections of the nasopharynx
Follicular Hyperplasia |
Chronic Tonsilitis
|
|
|
23 y/o female with nasal congestion
Exam shows narrowed left airway Exploratory surgery performed |
Inverted Papilloma
"Schneiderian" |
|
|
Highly vascular unencapsulated tumor, seen in adolescent males, present as epistaxis, biopsy is contra - indicated
|
Nasopharyngeal Angiofibroma
|
|
|
HPV associated
Proliferation of epithelial tissue, in nose, throat, mouth |
Papilloma
|
|
|
Extends into mucosa NOT exophytic growth (inverted)
Benign tumor but Locally aggressive (high recurrence rate) Rare progression to carcinoma |
Inverted Papilloma
"Schneiderian" |
|
|
Arising from neural crest cells
Highly malignant, metastasize widely Positive for NSE (Neuron-specific enolase) & S-100 (immuno stain), t(11:22) absent, has Pseudo- rosettes Small round blue cell tumors |
Olfactory Neuroblastoma
|
|
|
Sinuses
Malignant plasma cell tumor |
Plasmacytomas
|
|
|
12 y/o child with dysphagia
Exam large pharyngeal mass Mono spot ordered! Tumor associated with EBV Very rare in the US |
Nasopharyngeal Carcinoma
|
|
|
Subtypes of Nasopharyngeal Carcinoma
|
Keratinizing
Nonkeratinizing Undifferentiated Lymphoepithelioma |
|
|
Upper respiratory infection that is caused mainly by tobacco smoke
|
Laryngitis
|
|
|
What are the causes of laryngitis in children
|
Stridor due to narrowing of the airways
|
|
|
Effects of laryngitis on young infants
|
Laryngeal Edema
Obstruction and death |
|
|
Causes of croup in children
|
Laryngotracheobronchitis
|
|
|
Small lesions found on both sides of the vocal cords
Cause hoarseness of voice Never give rise to cancer |
Singer's Nodes
(Laryngeal Nodules) |
|
|
54 y/o male with hoarseness
Smokes 2 ppd Noticed a lump in his neck! Lymph node metastasis |
Squamous Cell Carcinoma
|
|
|
What is a sequence of the development of a cancer
|
Hyperplasia
Dysplasia Carcinoma |
|
|
Risk factors for SSC
|
Tobacco
Alcohol HPV |
|
|
Benign Lesions
1cm or less HPV 6 and 11 |
Papilloma
|
|
|
Related to HPV infection and form Koliocytes which show a perinuclear halo
|
Papilloma
|
|
|
Bacteria that cause Acute Otitis Media
|
Streptococcus
H.influenzea Moraxella |
|
|
Causes for Chronic Otitis Media
|
Pseudomonas
Staphylococcus Fungal |
|
|
Perforation
Mastoiditis Mengitis |
Chronic Otitis Media
|
|
|
Cholesteatoma
|
Chronic Otitis Media
|
|
|
Cholesterol Clefts with keratinous squamous epithelium
Granulomatous and behaves like tumor |
Cholesteatoma found in Chronic Otitis Media
|
|
|
Abnormal bone deposition of stapes
Bilateral and familial AD |
Otosclerosis
|
|
|
Tumors of the External Ear
|
Squamous
Basel Melanoma |
|
|
Tumors of Middle Ear
|
Anything goes
|
|
|
Cyst found at anterolateral neck ,Lined by stratified squamous or pseudostratified columnar epithelium,contain abundant lymphoid tissue
|
Branchial Cyst
|
|
|
Cyst Found anteriorly, midline, due to the remnants of thyroid developmental tract that persists producing cyst
|
Thyroglossal Duct Cyst
|
|
|
34 y/o female with a mass in her lateral neck
Exam - soft and cystic Ultrasound confirms cyst |
Branchial Cyst
|
|
|
35 y/o female with mass in medial neck
Exam soft Ultrasound cystic |
Thyroglossal Duct Cyst
|
|
|
62 y/o male with Hypertension
Dizziness and vertigo Dx - Carotid insufficiency Mass found arising from the carotid Blood pressure changes |
Paraganglioma
|
|
|
composed of nests (zellballen) of polygonal chief cells enclosed by trabeculae of fibrous and sustentacular elongated cells
|
Paraganglioma
|
|
|
Neuroendocrine markers :nonspecific enolase (NSE), S-100, chromogranin are positive
|
Paraganglioma
|
|
|
Derived from neuroendocrine cells (in adrenal medulla called –Pheochromocytomas)
|
Paraganglioma
|
|
|
Paravertebral
Sympathetic Chromaffin positive Elaborate catecholamines |
Paraganglioma
|
|
|
chromaffin body derived from neural crest located at the bifurcation of the aorta or at the origin of the inferior mesenteric artery. It can be the source of pheochromocytoma
|
Organ of Zukerkandl
|
|
|
Pheochromcytoma
Parathyroid Pituitary |
MEN 2
|
|
|
Dry mouth
|
Xerostomia
|
|
|
Which is more prone for malignancies Mucous or serous glands
|
Mucous glands
|
|
|
S.aureus and Strep. Viridans
Dehydration Impacted food |
Sialolithiasis
|
|
|
Stones formed and block the gland
|
Sialolithiasis
|
|
|
42 y/o female with dry mouth and eyes
Lab work up done Black dotted cells ANA positive SSa Atrophy of the tongue |
Sjogrens Syndroms
|
|
|
23 y/o male with lip lesion
Most common lesion Blockage or rupture Fluctuate with meals! Ranula - sublingual duct |
Mucocele
|
|
|
Most common Salivary Gland tumor
|
Benign Pleomorphic adenoma
|
|
|
52 y/o female
Mass in her neck Swelling anterior to the ear |
Pleomorphic Adenoma
|
|
|
Swelling in front of and below the ear
5th to 7th decade Slow growing and large |
Pleomorphic Adenoma
|
|
|
What is the most common tumor of the parotid
|
Pleomorphic Adenoma
|
|
|
51 y/o male with lateral neck mass
Exam soft and cystic Both solid and cystic lesions are seen |
Warthin Tumor
Papillary Cystadenoma Lymphomatosum |
|
|
Most common bilateral tumor of the parotid
|
Warthin Tumor
Papillary Cystadenoma Lymphomatosum |
|
|
2% reccurence rates
|
Warthin Tumor
Papillary Cystadenoma Lymphomatosum |
|
|
Most common malignant tumor of the salivary glands
|
Mucoepidermoid Carcinoma
|
|
|
What the chance of recurrance of mucoepidermoid carcinoma
|
Low grade 5 year survival of 90%
High grade 5 year is 50%! |
|
|
65 y/o male with mass
Floor of his mouth Painful-Perinueral invasion |
Adenoid Cystic Carcinoma
|
|
|
Most common rare malignant tumor of the parotid gland
|
Acinic Cell Carcinoma
|
|
|
Most common site for pathology for the upper GI tract
|
Gastroesophageal Junction
(GE junction). |
|
|
Being born and cant feed, hungry and very fussy, and get aspiration pnemonia and abnormal chest xray.
|
Tracheoesophageal fistula
|
|
|
Asthmatic symptoms, particularly nocturnal
Reflux of gastric contents into pharynx |
Regurgitation
|
|
|
Difficulty in transferring food to esophagus or in initiating swallowing
|
Oropharyngeal dysphagia
|
|
|
Difficulty in transporting down esophagus, food “gets stuck”
|
Esophageal dysphagia
|
|
|
Failure of GEJ to relax
|
Achalasia
|
|
|
Back pouching and most common esophageal motor dysfunction
|
Hiatal hernia (95%)
|
|
|
Disease that lives in the ganglion and causes achlasia
|
Chagas disease
|
|
|
Severe retching or violent vomiting
Usually alcoholics 5-10% of UGI bleeds, but usually not profuse Heals promptly |
Mallor-Weiss Laceration
|
|
|
Related to portal hypertension
90% of cirrhotics, usually alcoholics Also, schistosomiasis is causative worldwide Asymptomatic, until rupture causes massive hematemesis 40-50% fatality rate per episode |
Esophageal Varices
|
|
|
Caused by Lye Strictures
Candidiasis HSV and CMV GERD |
Esophagitis
|
|
|
Cowdry type A Inclusions
|
Show replication and HSV presence in Herpes Esophagitis
|
|
|
Heartburn
Regurgitation of gastric contents into pharynx Dysphagia |
GERD
|
|
|
Complication of GERD
|
Esophageal ulceration
Barrett Mucosa (Esophagus) Stricture with stenosis (narrowing) Long-term risk adenocarcinoma |
|
|
Reflux
Dysphagia Eosinophils Atopic |
Eosinophilic Esophagitis
|
|
|
Converstion from Squamous to Glandular mucosa
|
Barrett esophagus
|
|
|
Risk for Adenocarcinoma with 30-40 fold increase if >3 cm
|
Barrett esophagus
|
|
|
Immune disorder that can cause stricture in the esophagus
|
Scleroderma
|
|
|
Barretts esophagus transition
|
Squamous
Metaplasia Dysplasia Carcinoma |
|
|
Middle 1/3 Esophageal Cancer
|
SCC
|
|
|
Lower 1/3 Esophageal Cancer
|
Adenocarcinoma
|
|
|
Can barely eat food and drink most of the time
|
SSC
Mid Esophageal |
|
|
What is the common stage of SSC
|
Stage 4
|
|
|
Which tumor do you see Keratinization Pearls in
|
SSC
Mid Esophageal |
|
|
Most common benign tumor of the esophagus
|
Leiomyoma
|
|
|
Herpesviridae
Structure |
dsDNA
Enveloped Linear |
|
|
Herpes Infection patterns
|
Lytic
Persistent Latent or Transforming |
|
|
Herpes Theraputic Agent
|
Thymidine Kinase
|
|
|
HSV attachement Site
|
Heparan Sulfate
glycoprotein found on many cells |
|
|
Stages for HSV infection
|
Immediate: control gene transcription
Early: Polymerase and other enzymes Late: protein synthesis |
|
|
Epidemiology of HSV
|
Found in Secretions
Vaginal Saliva Vesicle Towels Glasses |
|
|
Clinical Features of HSV
|
Oral cold, sores, fever, blisters and genital vesicles
|
|
|
HSV Eruptions are caused by
|
fever
UV light menstruation local irriation |
|
|
Cowdry Type A acidophilic intranuclear inclusion bodies
|
HSV 1 and 2
|
|
|
Disease caused by HSV
|
Herpes pharyngitis
ocular keratitis Herpetic whitlow encephalitis (HSV 2) |
|
|
Lab diagnosis for HSV
|
Tzank Smear
Virus isolation |
|
|
Prevention of HSV
|
Avoid exposure
|
|
|
What is acyclovir
|
Its is used to mimic guanosine and prevent HSV
|
|
|
Thymidine Kinase
|
Receptor, therapeutic target
|
|
|
Binding site for EBV
|
CR2 of the B-cell
|
|
|
Outcomes after EBV binds to B-Cells
|
Permissive
Latent Immortalization of B cells |
|
|
EBV early Antigens
|
Early Antigen
Viral Capsid antigen |
|
|
EBV Latent Antigens
|
Non permissive, EBNA and LMP
|
|
|
Kissing disease
|
EBV
|
|
|
Virus spreads for a lifetime
|
EBV
|
|
|
Children Asymptomatic
|
EBV
M.Tb |
|
|
Infective Mononucleosis
|
EBV
|
|
|
Sore throat
Lymphadenopathy Splenomegaly |
Infective Mononucleosis
|
|
|
Burkitt's lymphoma
|
EBV
|
|
|
Nasopharyngeal Carcinoma
|
EBV
|
|
|
Lymphoproliferative Disease
|
EBV
|
|
|
Chromosome Effected with EBV
|
c-myc gene from chromosome 8/14 translocation
|
|
|
Downey Cells
|
Atyptical lymphocytes seen in EBV
|
|
|
Monospot Test
|
Heterophile Antibody for EBV
|
|
|
Antibodies tested for EBV
|
EA and EBNA
|
|
|
Which are the only organs that escape Tb infections
|
Tests and ovaries
|
|
|
Morphology of Neisseria meningitidis
|
Gram - Diplococci with a kidney bean shaped
|
|
|
Oxidase and catalase positive
|
N.Meningitidis
|
|
|
Oxidase test where dye changes color
|
N.Meningitidis
|
|
|
Polysaccharide capsule with 13 serologic groups A,B,C,Y and W135
|
N.Meningitidis
|
|
|
Normal flor of N.Meningitidis
|
Nose and throat
|
|
|
Move through sinuses and can even go to the brain
|
N.Meningitidis
|
|
|
Transmission of N.Meningitidis
|
Aerosols, college and school children
|
|
|
Effects children with later complement deficiency
|
N.Meningitidis
|
|
|
Contain antiphagocytic capusles and pilli
|
N.Meningitidis
H. Influenza |
|
|
Purulent, headache, fever, stiffness
|
Meningitis which is caused by N.meningitidis and H.Influenza
|
|
|
Petechia, purpura, thrombosis of small blood vessels, septic shock
|
Meningococcemia which is caused by N.Meningitidis
|
|
|
Bilateral renal gland hemorrhagic necrosis
|
Waterhouse-Friderichsen syndrome which is caused by N.Meningitidis
|
|
|
Chocolate agar, Thayer-martin chocolate agar
|
N.Meningitidis
|
|
|
Vaccines of four polysaccharides A,C,Y and W135 MPSV4
|
N.Meningitidis
|
|
|
MCV4 vaccine
|
N.Meningitidis
|
|
|
3 main human pathogens of H. Haemophilus
|
H.influenza
H.ducreyi H.aegyptius |
|
|
Conjuctivitis (pink eye)
|
H.Aegyptius
|
|
|
Chancroid an STD
|
H.ducreyi
|
|
|
What do H.Haemophilus require for growth
|
Hemin the X factor
NAD V factor |
|
|
Structure of H.Influenza
|
Six capuslar antigenic types, Polyribitol ribose phosphate (PRP), Hib.
|
|
|
Non-typable strains that lack a capsule
|
H.influenza
|
|
|
Cause Otitis Media and Sinusitis
|
H.influenza
|
|
|
Epiglottitis
|
H.Influenza
Can cause obstruction |
