12. Diseases of the Pharynx, Nasopharynx, Hypopharynx. Tonsillitis Flashcards
What are DISEASES of the NASOPHARYNX?
1) Adenoids
2) Juvenile Angiofibroma
What are ADENOIDS? (Nasopharynx)
- Small Tissues at BACK of the Throat
- Similar function to TONSILS
- Hypertrophy due to Viral / Bacterial Infection
0 SYMPTOMS
- Blocked Nose
- Ear Problems
- Snoring
- Mouth Breathing
- Cracked Lips
0 TREATMENT = Not Required
- Shrinks when Child grows older
- IF PERSISTS, Adenoidectomy is performed (after Childhood)
What is JUVENILE ANGIOFIBROMA ? (Nasopharynx)
- BENIGN Tumour of Nasopharynx
- But it’s LOCALLY AGGRESIVE + DESTROYS adjoining Structures
- Arises from POST-Part of Nasal Cavity = CLOSE TO Superior Margin of Sphenopalatine Foramen
- Grows into Nasal Cavity / Nasopharynx / Pterygopalatine Fossa / Cranial Fossa
0 SYMPTOMS
- Progressive Nasal OBSTRUCTION
- Hearing Loss
0 DIAGNOSIS
- MRI / CT
- Biopsy
Describe ACUTE TONSILLITIS
{Etiology, Symptoms, Diagnosis, Tests, Treatment}
- Acute Bacterial Inflammation of PALATINE TONSILS
- Aka STREPTOCOCCAL ANGINA
0 DUE to Group A beta-hemolytic Streptococci
- Staphylococci
- H. Influenzae
- Pneumococci
0 SYMPTOMS
- High Fever
- Severe Pain when swallowing - radiates to Ear
- Swollen Tonsillar LN
- Muffled Speech, due to Oropharyngeal Swelling
0 DIAGNOSIS = Both Tonsils are Swollen, BRIGHT Red, Coated
0 LAB TEST
- Leukocytosis
- INCREASED ESR
- INCREASED CRP
0 BACTERIA TESTING = Rapid Immunoassay
- IDENTIFIES Group A Streptococci in 10 mins
0 TREATMENT
- Penicillin V = 10 - 14 Days Course
- Macrolides / Oral Cephalosporin = IF ALLERGIC to Penicillin
- Analgesics = Pain Relief
Describe CHRONIC TONSILLITIS
{Etiology, Pathogenesis, Symptoms, Diagnosis, Treatment}
- Chronic Bacterial Inflammation of PALATINE TONSILS
0 DUE to RECURRENT INFLAMMATIONS by beta-hemolytic Streptococci
0 PATHOGENESIS
1) Scarring-like-Infections confined to Tonsillar CRYPTS
2) IMPAIRED Drainage of Crypts
3) Crypts COLONISED W/ Bacteria
4) Shedding of Bacteria / Inflammatory Mediators
0 SYMPTOMS = Recurrent Sore Throat / Bolus Sensation
0 DIAGNOSIS
- Small, Firm, Immobile Tonsils
- Peritonsillar Redness
- Purulent Liquid from Crypts
- Palpation = ENLARGED Tonsillar LN at Mandibular Angle
0 TREATMENT = Tonsillectomy
What is SCARLET FEVER?
- Fever caused by GROUP A STREPTOCOCCI
- Occurs in individuals who DO NOT have antibodies AGAINST them
- Infx STARTS in NASOPHARYNX, causing RASHES around neck, spreading to extremities
- Rash is DIFFUSED + GOOSE-BUMP Appearance
0 SYMPTOMS = Swollen Tongue with BRIGHT RED Papillae (Strawberry Tongue)
0 TREATMENT = Antibiotics for 10 Days
What is PLAUT-VINCENT ANGINA?
- Acute NECROTISING Infx of Pharynx
0 DUE to B. Vincentia AND Fusiform Bacilli
- Poor Oral Hygiene
- Infx from ANTHROP
0 SYMPTOMS
- Sore Throat
- Fevers
- Earache
0 TREATMENT = Antibiotics
What is DIPHTHERIA?
{Etiology, Pathogenesis, Symptoms, Complications, Diagnosis & Treatment}
- Acute Bacterial Infection
0 DUE to C. Diphtheria
- Soon as a person is infected via cough / sneeze = remains as virulent / persistent lesion for 2 - 4 weeks
———————————————————————
0 PATHOGENESIS
1) Primary Lesion in Upper RT
2) Necrosis of Epithelium, leading to Plasma Leakage
3) Fibrin Network Formation w/ Bacteria, causing Pseudo-membrane Formation
4) Adherent to underlying tissue = Nose / Pharynx / Larynx / Tonsils
0 SYMPTOMS
- Fever / Malaise / Sore Throat / Headache
0 COMPLICATIONS = Reach RF / Blurred Vision
0 DIAGNOSIS = Swab of Oropharynx / Larynx
0 TREATMENT = Antitoxins AND Antibiotics
What is INFECTIOUS MONONUCLEOSIS?
- Infection due to EPSTEIN-BARR VIRUS (EBV), from ORAL Secretions / Blood Transfusion from Infected person
0 SYMPTOMS = Sore throat / fever / rash
0 TREATMENT
- Glucocorticoid Therapy
- Anti-Viral Meds = Acyclovir
What is PERITONSILLAR ABSCESS?
{Etiology, Symptoms & Treatment}
- COLLECTION of PUS in SPACE BTW Tonsillar Capsule AND Superior Constrictor Muscle
0 DUE to TONSILLITIS - Bacterial infx (acute / chronic)
- Streptococcus Pyogenes
- Staphylococcus Aureus
0 SYMPTOMS
- Fever
- Body-ache
- Painful Swallowing
- Foul Breath
- Muffled Speech
0 TREATMENT
- Incision / Drainage
- IV Antibiotics
What is RETROPHARYNGEAL ABSCESS?
{Symptoms, Diagnosis & Treatment}
- TUBERCULAR NODE Infection
- PARANASAL SINUS Infection
0 SYMPTOMS
- Difficulty Breathing
- Croupy Cough
- Dysphalgia
0 DIAGNOSIS = ORAL Examination, a BULDGE is seen in the POST PHARYNGEAL WALL one 1 side of the MIDLINE
0 TREATMENT
- Incision / Drainage
- Systemic Antibiotics
What is PARAPHARYNGEAL ABSCESS?
- INFECTION of the ADENOIDS / TONSILS
- BURTSTING of the PERITUBULAR ASBCESS / LOWER Wisdom Tooth Abscess
0 SYMPTOMS
- External Swelling BEHIND ANGLE of Jaw
- Truisms
- Sore Throat
0 TREATMENT
- Incision / Drainage
- Antibiotics
