Pathoma: Chapter 9 – Questions With Solutions (A+)
Inflammation of the nasal mucosa Right Ans - Rhinitis
What is the most common cause of rhinitis? Right Ans - Rhinovirus
(adenovirus??)
What lines the nasal mucosa? Right Ans - Respiratory epithelium
How does rhinitis present? Right Ans - Sneezing, congestion, runny nose
(common cold)
Subtype of rhinitis Right Ans - Allergic rhinitis (Type I Hypersensitivity)
What type of hypersensitivity reaction is allergic rhinitis? Right Ans - Type
I
What is allergic rhinitis associated with (2)? Right Ans - Asthma
Eczema
What is allergic rhinitis characterized by? Right Ans - Characterized by
inflammatory infiltrate with eosinophils
What is the consequence of repeated bouts of rhinitis? Right Ans - Nasal
polyp
Protrusion of edematous, inflamed mucosa Right Ans - Nasal polyp
What causes nasal polyps (3 things)? Right Ans - Repeated rhinitis, CF,
aspirin-intolerant asthma
What do you test a child with nasal polyps for? Right Ans - Cystic fibrosis
Triad of aspirin-intolerant asthma Right Ans - 1. Asthma
2. Aspirin-induced bronchospasms
3. Nasal polyps
What percentage of asthmatic adults have aspirin-intolerant asthma? Right
Ans - 10%
,Benign tumor of nasal mucosa composed of large blood vessels and fibrous
tissue Right Ans - Angiofibroma
Classic age/sex of angiofibroma Right Ans - Teenage male
How does angiofibroma present? Right Ans - Teenage male with diffuse
epistaxis
Malignant tumor of nasopharyngeal epithelium Right Ans -
Nasopharyngeal carcinoma
What is nasopharyngeal carcinoma associated with? Right Ans - EBV
Who does nasopharyngeal carcinoma classically appear in (2 demographics)
Right Ans - African children and Chinese adults
Biopsy of pleomorphic keratin-positive epithelial cells in a background of
lymphocytes is typical of what disease? Right Ans - Nasopharyngeal
carcinoma
Biopsy of nasopharyngeal carcinoma Right Ans - Shows pleomorphic
keratin-positive epithelial cells in a background of lymphocytes
What lymph nodes does nasopharyngeal carcinoma typically involve/present
with? Right Ans - Cervical lymph nodes
Chinese adult male with large cervical lymph nodes Right Ans - Typical
presentation of nasopharyngeal carcinoma
What is the intermediate filament of epithelial cells? Right Ans - Keratin
Acute epiglottitis definition Right Ans - Inflammation of the epiglottis
Name the two risk factors for laryngeal carcinoma Right Ans - Tobacco and
alcohol
Inflammation of the epiglottis Right Ans - Acute epiglottitis (medical
emergency)
,What is the most common cause of acute epiglottitis? Right Ans - H
influenzae type B (in both immunized and non-immunized children)
How does acute epiglottitis present? Right Ans - High fever, sore throat,
drooling with dysphagia, muffled voice, inspiratory stridor
What is the main risk of acute epiglottitis? Right Ans - Airway obstruction
(medical emergency!)
What's another name for croup Right Ans - Laryngotracheobronchitis
What is the most common cause of Laryngotracheobronchitis (croup)
Right Ans - Parainfluenza virus
Inflammation of the upper airway Right Ans - Laryngotracheobronchitis
(croup)
How does Laryngotracheobronchitis (croup) present? Right Ans - Hoarse,
"barking" cough and inspiratory stridor
Nodule that arises on the true vocal cord Right Ans - Vocal cord nodule
(singer's nodule)
Is vocal cord nodule usually bilateral or unilater? Right Ans - Bilateral
What causes vocal cord nodule? Right Ans - Excessive use of vocal cords
What is vocal cord nodule composed of histologically? Right Ans - Myxoid
(degenerative) connective tissue
Treatment of vocal cord nodule? Right Ans - Resting of voice
How does vocal cord nodule present? Right Ans - Hoarseness
Benign papillary tumor of the vocal cord Right Ans - Laryngeal papilloma
What causes laryngeal papilloma? Right Ans - HPV 6 and 11 (associated
with koilocytic change in biopsy)
, What is the difference in laryngeal papillomas between adults and children?
Right Ans - Adults: single
Children: multiple
How does laryngeal papilloma present? Right Ans - Hoarseness
Squamous cell carcinoma arising from the epithelial lining of the vocal cord
(usually) Right Ans - Laryngeal carcinoma
What are the risk factors (2 main, 3rd rare) for laryngeal carcinoma? Right
Ans - Alcohol and tobacco; rarely arises from laryngeal papilloma
How does laryngeal carcinoma present? Right Ans - Hoarseness, cough,
stridor
What lines the vocal cords? Right Ans - Squamous epithelium
Infection of the lung parenchyma Right Ans - Pneumonia
When does pneumonia occur? Right Ans - When normal defenses are
impaired
What are the normal defenses that when impaired can contribute to
pneumonia development (3)? Right Ans - 1. Impaired cough reflex
2. damage to mucociliary escalator
3. mucus plugging
What is the mucociliary escalatory, and how can it become damaged? Right
Ans - The lungs are lined by ciliated epithelium, and the cilia help push mucus
up out of the airway to be swallowed. It can become damaged in a viral
pneumonia, which will then increase the risk of a superimposed bacterial
pneumonia
Clinical features of pneumonia Right Ans - Fever and chills, productive
cough with yellow-green (pus) or rusty (blood) sputum, tachypnea with
pleuritic chest pain, decreased breath sounds, dullness to percussion, elevated
WBC
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