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(Module)
INTRODUCTION
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ANATOMY
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ANATOMY
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ANATOMY
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Physiology of pharynx
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3.
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Waldeyers Ring
Palatina tonsil (faucial)
Pharingeal tonsil (adenoid)
Lingual tonsils
Lateral pharyngeal band
Soliter noduls of posterior pharingeal wall
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PHARYNGITIS
1.
2.
3.
4.
5.
6.
7.
8.
Bacterial Infection.
Viral Infection.
Fungal Infection.
Parasitic Infection.
Infectious Granulomatous Disease.
Non Infectious Granulomatous Disease.
Integumental and Connective Tissue Disorders.
Idiopathic Pharyngitis.
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BACTERIAL INFECTION
1.
2.
3.
4.
5.
6.
7.
8.
9.
Streptococcal Infection.
Scarlet Fever.
Staphylococcal Infection.
Diphteri.
Haemophillus Infection.
Pertussis.
Gonorrhea
Syphillis.
Rhinoscleroma.
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STREPTOCOCCAL INFECTION
Diagnosis : culture
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http://www.guideline.gov/summary/
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SCARLET FEVER
Diagnosis : culture.
Treatment : antibiotic
cephalosporins).
(penicillins,
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erythromycin,
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SCARLET FEVER
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STAPHYLOCOCCAL INFECTION
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STAPHYLOCOCCAL INFECTION
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DIPHTEROID INFECTION
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DIPHTEROID INFECTION
http://www.dipnet.org/general.public.php
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http://www.dipnet.org/general.public.php
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PERTUSSIS
(whooping cough)
Treatment : self-limiting.
Immunization.
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PERTUSSIS
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http://www.who.int/entity/healthinfo/statistics/bodgbddeathdalyestimates.xls
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HAEMOPHILLUS INFECTION
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GONORRHEA
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SYPHILLIS
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SYPHILLIS
Pharyngotonsillitis
erosions.
mucous
patches
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painless,
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SYPHILLIS
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RHINOSCLEROMA
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VIRAL INFECTION
1.
2.
3.
4.
5.
6.
7.
Measles.
Herpes Simplex Virus.
Varicella Zoster.
Cytomegalovirus.
Epstein-Barr Virus.
Human Imunodeficiency Virus.
Hand, Foot, and Mouth disease.
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MEASLES
Morbilli virus.
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Histopathologic : multinucleated
intranuclear inclusions.
giant
cells
and
Management : symptomatic.
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EPSTEIN-BARR VIRUS
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CYTOMEGALOVIRUS
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HUMAN IMUNODEFICIENCY
VIRUS
Association with
syndrome (AIDS).
acquired
immunodeficiency
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http://www.cdc.gov/ncidod/dvrd/revb/enterovirus/hfhf.htm
http://www.infeksi.com/articles.php?lng=in&pg=44
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Recorded outbreaks
http://wwwnc.cdc.gov/travel/content/outbreak-notice/hand-foot-mouth-disease-china-2010.aspx
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Course of disease
http://humanenterovirus71.wordpress.com/
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FUNGAL INFECTION
1.
Candida Infection.
2.
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CANDIDA INFECTION
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CANDIDA INFECTION
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PARASITIC INFECTION
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INFECTIOUS GRANULOMATOUS
DISEASES
1.
Tuberculosis.
2.
Leprosy
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TUBERCULOSIS
Treatment : medications
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LEPROSY
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1.
2.
3.
Wegeners Granulomatosis.
Chrons Disease.
Sarcoidosis.
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WEGENERS
GRANULOMATOSIS
Idiopathic,
multisystem disorder.
Characterized : necrotizing, granulomatous inflammation
and a vasculitis.
Diagnosis : the antineutrophil cytoplasmic antibody
(ANCA).
Treatment : prednisolone, cyclophosphamide, and other
immunosuppressant agents.
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CHRONS DISEASE
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SARCOIDOSIS
Unknown etiology.
Presents with hilar lymphadenopathy and pulmonary and
cutaneous involvement.
Pharyngeal involvement : inflammatory process, and
tonsillar hyperplasia.
The diagnosis : clinical, radiologic, and pathologic
findings (Schaumann bodies).
Treatment : corticosteroid therapy.
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INTEGUMENTAL
AND
CONNECTIVE TISSUE DISORDERS
1.
2.
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STEVENS JOHNSONS
SYNDROME
Histologically
:
liquefaction
degeneration,
intraepithelial vesicles and subepidermal bullae .
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PEMPHIGUS
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Others Cause of
Pharyngitis
Reflux Pharyngitis
GERD, hiatal hernia, and positive gastrytis
Helicobacter pylor
Hoarsness, sore throat, chronic cough, globus
sensation, halitosis, cervikal dyphagia, laryngeal and
esophageal malignancy
Mild pharyngeal erytheme, interarythenoid edeme
Treatment : PPI, behavioral
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Berlucchi Marco and Dr Piero Nicolai. Marshalls syndrome or PFAPA (periodic fever, aphthous stomatitis,
pharyngitis, cervical adenitis) syndrome. 2004.
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Pharyngitis
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Radiation Pharyngitis
Radiotherapy 16 - 22 cGy mucosal atropy
Low saliva (effects on major dan minor salivary
glands) predisposes superinfection of
bacterial/fungal of pharynx
Symptomatical therapy
Sucralfat, dyphenhydramin, antibacterial agent, and
topical steroid
Pylocarpin
Bailey Byron J.and Jonas T. Johnson. Head and Neck Surgery Otolaryngology, 4 th edition. Volume 1.
Philadelphia: Lippincot, William and Wilkins, 2006.
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IDIOPATHIC PHARINGITIS
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Chronic pharyngitis
Hypertophy of mucosa, seromucinous glands,
subepithelial lymphoid follicles, muscular coat of the
pharynx
Treatment :
Etiological factors
Stop habits ; hawking,
throat clearing freuquently
Granular pharyngitis
Cauter: 10-25% silver nitrate
, electrocautery/diathermy
Atrophic pharyngitis
pharyngeal irrigation
Potassium iodide orally; promote secretion, prevents crusting
Bailey Byron J.and Jonas T. Johnson. Head and Neck Surgery Otolaryngology, 4th edition. Volume 1. Philadelphia:
Lippincot, William and Wilkins, 2006.
Dhingra P.L. Disease of Ear, Nose and Throat, 4th edition. Noida-India: Elsevier, 2007.
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HIGHLIGTHS
Pharyngitis is one of the most common disorders affecting
the head and neck.
Causes of pharyngitis include infection, inflammation, and
congenital disorders.
Diagnosis of pharyngitis is based on a careful history and
physical examination.
Aerobic and anaerobic bacterial cultures may be required to
establish a diagnosis of bacterial infection.
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HIGHLIGTHS
Viral cultures are uncommonly justified in managing patients with
pharyngitis.
Mycoses are uncommon causes of pharyngitis and require special
stains and cultures for diagnosis.
Granulomatous inflammation may result from infectious agents,
systemic diseases (Wegeners granulomatosis), foreign material, or
neoplasms.
Persistent symptoms of pharyngitis may result from postnasal
drainage or reflux esophagitis.
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HIGHLIGTHS
Effective treatment of any pharyngeal lesion requires
establishing a correct diagnosis.
Failure of a pharyngeal lesion to resolve with empiric
therapies requires appropriate cultures or biopsy.
Major complications of pharyngitis include uncontrolled
sepsis, hemorrhage, or airway obstruction.
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Thank You
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