Pulmonary - Sinonasal Pathology

Sun exposed skin of the face, lip, ears, scalp,neck, arms, etc are at an increased risk of developing...

solar (actinic) keratosis

what pathology may remain stable, may regress, may progress to SCC?

solar actinic keratosis

scaly plaques are a presentation of what pathology?

solar (actinic) karetosis

what pathology is

- Slow growing

- Rarely metastasizes

- and is caused by Loss of function mutation in PTCH1

basal cell carcinoma

T or F: basal cell carcinoma rarely metastasizes

TRUE

basal cell carcinoma is caused by what genetic component?

loss of function mutation in PTCH1

what is the greatest risk factor for basal cell carcinoma?

chronic sun exposure

how is basal cell carcinoma treated?

local excision

what is the probability that someone who has developed a basal cell carcinoma previously will develop another within 5 years?

40%

_____% of basal cell carcinoma patients develop another basal cell within 5 years

40%

Systemic lupus (SLE) Affects many organ systems including the skin in a disease called...

lupus erythematosus

Discoid rash: erythematous raised patches with adherent keratotic scaling and follicular plugging

this describes what pathology?

lupus erythematosus

T or F: only one factor plays a role in pathogenesis of lupus erythematosus

FALSE

- many factors

T or F: UV light exacerbates lupus erythematosus in many patients?

True

is lupus erythematosus autoimmune?

YES

what pathology can present as Malar rash (fixed erythema, flat or raised, over the malar eminences), photosensitivity?

lupus erythematosus

what pathology is a Form of rosacea?

Rhinophyma

what is the predilection of rhinophyma

common in men (12-30:1 ratio)

• Hypertrophy, follicular dilation, hyperplasia of sebaceous glands

• Fibrosis

• Increased vascularity

the above are characteristics of what pathology?

rhinophyma

Inflammation of the nasal cavity =

rhinitis

inflammation of the sinuses =

sinusitis

inflammation of both the nasal cavity and the sinuses =

rhinosinusitis

infectious rhinitis is also known as...

common cold

T or F: infectious rhinitis is only caused by one virus

FALSE

- can be caused by one or more

adenoviruses, echoviruses, and rhinoviruses are usually involved in what pathology?

infectious rhinitis

what sign will you expect to see in infectious rhinitis?

excessive nasal discharge

Clear nasal discharge, sneezing, itching after exposure to allergen is characteristic of...

allergic rhinitis

Repeated attacks of acute rhinitis is...

chronic rhinitis

- can be allergic or microbial

chronic microbial rhinitis may result from...

polyps or deviated septum

nasal polyps are most often associated with what?

- allergic rhinitis

Infections, asthma, aspirin intolerance, cystic fibrosis, diabetes are other causes

nasal polyps are most often associated with allergic rhinitis, what are other causes?

Infections, asthma, aspirin intolerance, cystic fibrosis, diabetes are other causes

epistaxis is commonly known as...

nosebleeds

- highly vascular nasal submucosa

• Trauma

• Hereditary hemorrhagic telangiectasia (HHT)

• Hypertension

• Thrombocytopenia

• Nasopharyngeal angiofibroma

• Sarcoidosis

• Granulomatosis with polyangiitis (Wegener granulomatosis)

• Hemangioma

the above are all etiologies of what?

epistaxis

loss of smell is also known as...

anosmia

the are 2 categories of anomsia:

obstructive

sensorineural

what 4 pathologies can cause obstructive anosmia?

• Rhinitis

• Sinusitis

• Nasal polyps

• Tumors

what 2 pathologies can cause sensorineural anosmia?

- trauma

- tumors

what precedes acute maxillary sinusitis?

acute or chronic rhinitis

what can result from periapical infection?

acute maxillary sinusitis

thickened, acutely inflamed sinus membranes is characteristic of...

acute maxillary sinusitis

can there be secondary bacterial infections in acute maxillary sinusitis?

YES

what is important to note about drainage in the case of acute maxillary sinusitis?

Drainage cannot occur due to inflammatory edema

- can occur at ostia

Severe infections in what pathology can involve ethmoid and frontal sinuses and meninges of brain?

acute maxillary sinusitis

what Results from recurring episodes of acute sinusitis or symptomatic disease lastinglonger than 3 months?

chronic maxillary sinusitis

chronic maxillary sinusitis is caused by?

drainage failure of acute inflamed sinus

what can be mistaken for a painful, abscessed tooth?

chronic maxillary sinusitis

T or F: chronic maxillary sinusitis can be caused by fungal infection

TRUE

Mucormycosis is seen in what groups?

immunocompromised like uncontrolled diabetics

what are other factors that can cause chronic maxillary sinusitis?

• Cigarette smoke

• Allergies

• Deviated nasal septum

• Nasal polyps

is malignant transformation possible in Fungiform and inverted papillomas?

YES

• Hamartoma, usually at septum

• Epistaxis

are characteristics of what pathology?

hemangioma (vascular malformation)

Fungiform and inverted papillomas contain...

respiratory epithelium

• Papillary appearance

• HPV

these are characteristics of what pathology?

squamous papilloma

hamartomas in hemangioma (vascular malformation) are usually where?

nasal septum

what pathology is a vascular tumor that exclusively affects adolescent males and young men, may mimic malignancy and presents with epistaxis?

nasopharyngeal angiofibroma

what is a vascular tumor that may mimic malignancy?

nasopharyngeal angiofibroma

what malignant tumor affects the paranasal sinuses?

squamous cell carcinoma

what pathology?

• Causes erosion

• Maxillary sinus most often affected

squamous cell carcinoma

malignant tumor of the paranasal sinus

what sinus is most often affected in squamous cell carcinoma?

maxillary sinus

what malignant tumor of the nasopharynx is caused by Epstein-barr virus (EBV)?

nasopharyngeal carcinoma

what pathology?

• Caused by Epstein-barr virus (EBV)

• Prevalent in China, Southeast Asia and East Africa (Smoking, Salted fish, Pickled food)

• Early metastasis, late detection

nasopharyngeal carcinoma

the following is the clinical presentation of what pathology?

• Nasal obstruction

• Epistaxis

• Cervical lymph node metastasis

nasopharyngeal carcinoma

what pathology is prevalent in China, SW Asia and East Africa?

nasopharyngeal carcinoma

what stage of nasopharyngeal carcinoma?

the tumor is confined to the nasopharynx/has extended to the oropharynx and/or nasal cavity without parapharyngeal extension

stage 1

what stage of nasopharyngeal carcinoma?

the tumor has extended beyond the nasopharynx with/without spreading to unilateral cervical lymph nodes/behind the throat

stage 2

what stage of nasopharyngeal carcinoma?

the tumor has spread to bilateral cervical lymph nodes or the tumor has invaded the skull base/nasal cavity

stage 3

what stage of nasopharyngeal carcinoma?

the tumor has extended to part of the brain/lower part of the throat. It may also have extensive lymph node involvement (size>6 cm/to the lowest part of the neck)

stage 4A

what stage of nasopharyngeal carcinoma?

the tumor has spread to distant sites such as the liver, bones and lungs

stage 4B

these 4 strictures form what?

• Palatine tonsils (tonsils)

• Nasopharyngeal tonsils (adenoids)

• Lingual tonsils

• Tubal tonsils (Eustachian)

Waldeyer's ring

• Common cold

• Influenza

• Mononucleosis (caused by EBV)

• Other viral respiratory tract infections

these are common infections of what part of the body?

the oropharynx

what is the most common cause of tonsillar enlargement

reactive lymphoid hyperplasia

what is the most common pharyngitis that also usually accompanies a cold?

mild pharyngitis

these are characteristics of what?

• Can accompany β-hemolytic streptococcal and adenovirus infection

• Potential for peritonsillar abscess "Quinsy"

• Acute rheumatic fever

• Acute post-streptococcal glomerulonephritis

more severe pharyngitis and tonsillitis

what is caused by Corynebacterium diphtheria?

Diphtheria

what pathogens usually discovered in individuals that have contact with farm animals or dairy products?

diphtheria

what pathology includes a bacterial infection (Corynebacterium diphtheria) that is transmitted via contact with infected person or carrier through respiratory droplets

diphtheria

what pathology results in obstructive asphyxia due to a pseudomembrane produced on soft palate and pharynx?

diphtheria

diphtheria symptoms:

fever, malaise, sore throat, neck swelling

what pathology/infection involves produces an exotoxin that causes necrosis and affects heart and nerves

diphtheria caused by Corynebacterium diphtheria

Corynebacterium diphtheria produces a exotoxin does what and affects what organs?

causes necrosis and affects the heart and nerves

does Corynebacterium diphtheria produce an endotoxin or exotoxin?

exotoxin

T or F: diphtheria is common

FALSE

- rare occurrence since vaccine was developed

the epiglottis, false cords, ventricles, saccules are all in what region of the larynx?

supraglottis

the true vocal cords, ant. & post.commissures, vocal processes of arytenoids are all in what region of the larynx?

glottis

below true vocal cords to lower border of cricoid cartilage describes what region of the larynx?

subglottis

what is caused by inhaling irritants, allergic reaction, or common cold and results in hoarseness and/or temporary loss of voice?

acute laryngitis

diphtheria laryngitis produces?

what exotoxins and pseudomembrane

tuberculosis laryngitis results from

infected, coughed-up sputum

croup is also known as...

laryngotracheobronchitis

the following are characteristics of what pathology?

• Harsh persistent cough

• Caused by parainfluenza virus

• Affects children

• Self-limiting

• Respiratory failure can occur- laryngeal inflammation narrows airway

Croup (laryngotracheobronchitis)

Acute toxic laryngitis is caused by...

toxic fumes

Chronic toxic laryngitis is caused by...

results from cigarettes, premalignant

Angioedema is the result of...

type 1 hypersensitivity reaction

in the case of polyps, chronic irritation is usually caused by what?

heavy smokers

the following is the clinical presentation of what

• Unilateral

• Smooth and round

• Can be sessile or pedunculated

polyps (on vocal cords)

what is caused by chronic irritation and strain, affects true vocal cords with progressive hoarseness and presents as bilateral lesions?

Singer's nodules (vocal cord nodules)

treatment for Singer's nodules (vocal cord nodules)

• Voice or speech therapy

• Behavior modification

what is human papillomavirus (HPV)

squamous papilloma of the larynx

where does squamous papilloma of the larynx occur?

true vocal cords

what pathology present solitarily in adults but with multiple in children?

squamous papilloma of the larynx