SlideShare une entreprise Scribd logo
1  sur  44
Universidad de Guadalajara
             Centro Universitario Ciencias de la Salud




       Head and Neck
        Pathology
Giovanna Lazcano Sherman
                            Dr. Héctor Manuel Virgen Ayala
     September 2011          Dr. Benjamín Robles Mariscal
Peritonsillar
 Abscess
Peritonsillar Abscess




F. H. Netter. “Atlas de anatomía humana”, Second edition. 2001, Page. 69.
Secondary…

         Acute tonsillitis

  Duct Obstruction Weber
Reason for consultation
Physical Examination




   W. J. Spicer. “Microbiología Medica y Enfermedades
     Infecciosas”, Second edition. 2009, Page. 118.
Diagnosis
Aspiretion   Needle
             Insicion


        Drein the
        abscess
Thyroglossal duct
      cyst
Thyroid Embryology




S. Langman. “Embriología Médica con orientación clínica”, 10ª edition.
                         2007, Page. 281.
In the route
of blind hole,
  can remain
  thyroid
  tissue.        S. Langman. “Embriología Médica con
                 orientación clínica”, 10ª edition. 2007,
                               Page. 281.
F. H. Netter. “Sistema endocríno y enferedades metabólicas”, 1ª
                     edition. 2006, Page. 45.
Differencial Diagnosis




    N. Wood; P.W Woaz.
“Diagnóstico diferencial de las
      lesiones orales y
  maxilofaciales”, 5ª edition.
      1998, Page. 535
Complications
Infections
        Malignancy
       papillary thyroid
          carcinoma
Diagnosis
Aspiration   Needle
             Insicion

Scintigraphy
Scintigraphy




  PLoS Medicine: Perros P (2005) Thyrotoxicosis and Pregnancy. PLoS Med 2(12): e370
doi:10.1371/journal.pmed.0020370 ( http://medicine.plosjournals.org/perlserv/?request=get-
                     document&doi=10.1371/journal.pmed.0020370)
Treatment




                              Sistrunk procedure
L. Torrico. J. Rivero. K. Vasquez “Caso Clínico de Quiste Tirogloso”, recovered
 http://www.univalle.edu/publicaciones/revista_salud/revista06/pagina10.htm
Thyroid
Neoplasms
Histology




A. Stevens; J.Lowe. “Histología Humana”, 3ª edition. 2006, Page. 279.
Thyroid nodules
We have several methods for
 evaluating thyroid nodules
        and classify.

     The interrogation and physical
       examination are so important
Examinations would be useful,
     thyroid hormones,
   ultrasounds, biopsies,
imaging with radio-iodine, x-
       rays, CT, MR.
Thyroid nodules




         R.F. Lick. “Atlas de patología quirúrgica”, 1ª
                            edition. 1981, Page. 47.
Recurrent goiter




R.F. Lick. “Atlas de patología quirúrgica”, 1ª edition. 1981, Page. 49.
Papillary
                   adenocarcinoma




                        85%
R.F. Lick. “Atlas de patología quirúrgica”, 1ª
edition. 1981, Page. 53.
Follicular
        adenocarcinoma
                                  10%


 R.F. Lick. “Atlas de patología
quirúrgica”, 1ª edition. 1981,
           Page. 47.
Follicular
adenocarcinoma




 R.F. Lick. “Atlas de patología
   quirúrgica”, 1ª edition.
       1981, Page. 51.
Medullary carcinoma
                                              7%
Carcinoma that
causes 15% of
  deaths from
 thyroid cancer   Barbara F. Atkinson. “Atlas de Diagnostico
                  Citopatologico”, 2ª edition. 2005, Page.
                                    494.
Medullary carcinoma

     Doesn’t absorb
   radioactive iodine
    and produces
     calcitonin
Undifferentiated
  carcinoma

1%



          R.F. Lick. “Atlas de patología quirúrgica”, 1ª
                             edition. 1981, Page. 53.
Parathyroid
Histology




A. Stevens; J.Lowe. “Histología Humana”, 3ª edition. 2006, Page. 279.
Anatomy




K. L. Moore; A. F. Delley. “Anatomía con orientación
       clínica”, 5ª edition. 2006, Page. 279.
Physiology




            Goldman; Ausiello. “Cecil,
         tratado de medicina interna”,
        23ª edition. 2006, Page. 1113.
Primary
hyperparathyroidism
Arises from 0.1 to 0.3%
    of the population


      most common cause of
           hypercalcemia
Causes
Parathyroid adenoma    83%
Multiple adenoma       6%
Hyperplasia            10%
Carcinoma              1%
Parathyroid adenoma




   R.F. Lick. “Atlas de patología quirúrgica”, 1ª edition. 1981,
                             Page. 51.
90% of all cases responsible
  for hypercalcemia are
    hyperparathyroidism and
                      cancer
Diagnosis

Clinical findings
      and
Laboratory tests
Laboratory tests


calcium          phosphate

   parathyroid hormone
Bone scans
                                             Bone
                                      densitometry

                                          X. Rays

              Recovered
http://intercambiosos.org/showthrea
            d.php?t=4558
Differencial Diagnosis
  Cancer
                         Hyperthyroid
               Thiazide diuretics
       Milk-alkali syndrome
Familial hypocalciuric
hypercalcemia
Secondary
        Terciary
Hyperparathyroidism
Parathyroidectomy   Treatment




                                 Hypoparathyroidism
Recovered http://www.elsevier.es/es/redirect/deprecated?_f=7214&articuloid=13109149
Bibliography
 G. M. Doherty. “Diagnóstico y tratamiento
Quirúrgicos”, thirteenth edition, México; 2006.
      Page. 204-205; 224-240 & 1013.

 L. Goldman; D. Ausiello. “Cecil, tratado de
  medicina interna” 23ª edition; Barcelona;
            España, 2009. Page.

Contenu connexe

Tendances

Crimson Publishers-An Unusual Case of Secondary in Sphenoid Sinus from Carcin...
Crimson Publishers-An Unusual Case of Secondary in Sphenoid Sinus from Carcin...Crimson Publishers-An Unusual Case of Secondary in Sphenoid Sinus from Carcin...
Crimson Publishers-An Unusual Case of Secondary in Sphenoid Sinus from Carcin...CromsonPublishersotolaryngology
 
Parotid Gland Oncocytoma: A Case Report
Parotid Gland Oncocytoma: A Case ReportParotid Gland Oncocytoma: A Case Report
Parotid Gland Oncocytoma: A Case Reportiosrjce
 
DNA– REPAIRING PROTEIN MAY BE KEY TO PREVENTING RECURRENCE OF SOME CANCER ...
DNA– REPAIRING PROTEIN MAY BE KEY TO PREVENTING RECURRENCE OF SOME CANCER    ...DNA– REPAIRING PROTEIN MAY BE KEY TO PREVENTING RECURRENCE OF SOME CANCER    ...
DNA– REPAIRING PROTEIN MAY BE KEY TO PREVENTING RECURRENCE OF SOME CANCER ...Natyperilla
 
Seminario Biología molecular
Seminario Biología molecularSeminario Biología molecular
Seminario Biología molecularAndre Urrego
 
The molecular times
The molecular timesThe molecular times
The molecular timesjonyfive5
 
Prognostic & predictive factors of breast cancer
Prognostic & predictive factors of breast cancerPrognostic & predictive factors of breast cancer
Prognostic & predictive factors of breast cancerMohammed Fathy
 
A Strange Association Between A Rectum- Infiltrating / Metastatic Dedifferent...
A Strange Association Between A Rectum- Infiltrating / Metastatic Dedifferent...A Strange Association Between A Rectum- Infiltrating / Metastatic Dedifferent...
A Strange Association Between A Rectum- Infiltrating / Metastatic Dedifferent...CrimsonpublishersCancer
 
Gene Expression Patterns_in_Ovarian_Carcinomas
Gene Expression Patterns_in_Ovarian_CarcinomasGene Expression Patterns_in_Ovarian_Carcinomas
Gene Expression Patterns_in_Ovarian_Carcinomasdewisetiyana52
 
88 24-1853 051.812.955.17 folder to Tax Return
88 24-1853  051.812.955.17 folder to Tax Return88 24-1853  051.812.955.17 folder to Tax Return
88 24-1853 051.812.955.17 folder to Tax ReturnSandro Suzart
 
DNA Methylation in Young Women Breast Cancer
DNA Methylation in Young Women Breast CancerDNA Methylation in Young Women Breast Cancer
DNA Methylation in Young Women Breast CancerPedro Penzuti Pacheco
 
Ewings sarcoma management Chemotherapy trials
Ewings sarcoma management Chemotherapy trialsEwings sarcoma management Chemotherapy trials
Ewings sarcoma management Chemotherapy trialsParag Roy
 
Swjcst comparison of risk factors and molecular analysis of right sided colon...
Swjcst comparison of risk factors and molecular analysis of right sided colon...Swjcst comparison of risk factors and molecular analysis of right sided colon...
Swjcst comparison of risk factors and molecular analysis of right sided colon...M. Luisetto Pharm.D.Spec. Pharmacology
 

Tendances (20)

Crimson Publishers-An Unusual Case of Secondary in Sphenoid Sinus from Carcin...
Crimson Publishers-An Unusual Case of Secondary in Sphenoid Sinus from Carcin...Crimson Publishers-An Unusual Case of Secondary in Sphenoid Sinus from Carcin...
Crimson Publishers-An Unusual Case of Secondary in Sphenoid Sinus from Carcin...
 
Parotid Gland Oncocytoma: A Case Report
Parotid Gland Oncocytoma: A Case ReportParotid Gland Oncocytoma: A Case Report
Parotid Gland Oncocytoma: A Case Report
 
Folding
FoldingFolding
Folding
 
DNA– REPAIRING PROTEIN MAY BE KEY TO PREVENTING RECURRENCE OF SOME CANCER ...
DNA– REPAIRING PROTEIN MAY BE KEY TO PREVENTING RECURRENCE OF SOME CANCER    ...DNA– REPAIRING PROTEIN MAY BE KEY TO PREVENTING RECURRENCE OF SOME CANCER    ...
DNA– REPAIRING PROTEIN MAY BE KEY TO PREVENTING RECURRENCE OF SOME CANCER ...
 
Seminario Biología molecular
Seminario Biología molecularSeminario Biología molecular
Seminario Biología molecular
 
CHROMOSOMES
CHROMOSOMES CHROMOSOMES
CHROMOSOMES
 
Prostate disorders
Prostate disordersProstate disorders
Prostate disorders
 
Long term survival NBL
Long term survival NBLLong term survival NBL
Long term survival NBL
 
The molecular times
The molecular timesThe molecular times
The molecular times
 
Prognostic & predictive factors of breast cancer
Prognostic & predictive factors of breast cancerPrognostic & predictive factors of breast cancer
Prognostic & predictive factors of breast cancer
 
PSEUDOMELANOMAS OF THE
PSEUDOMELANOMAS OF THEPSEUDOMELANOMAS OF THE
PSEUDOMELANOMAS OF THE
 
A Strange Association Between A Rectum- Infiltrating / Metastatic Dedifferent...
A Strange Association Between A Rectum- Infiltrating / Metastatic Dedifferent...A Strange Association Between A Rectum- Infiltrating / Metastatic Dedifferent...
A Strange Association Between A Rectum- Infiltrating / Metastatic Dedifferent...
 
Gene Expression Patterns_in_Ovarian_Carcinomas
Gene Expression Patterns_in_Ovarian_CarcinomasGene Expression Patterns_in_Ovarian_Carcinomas
Gene Expression Patterns_in_Ovarian_Carcinomas
 
CV - Jessica Spies, MD
CV - Jessica Spies, MDCV - Jessica Spies, MD
CV - Jessica Spies, MD
 
88 24-1853 051.812.955.17 folder to Tax Return
88 24-1853  051.812.955.17 folder to Tax Return88 24-1853  051.812.955.17 folder to Tax Return
88 24-1853 051.812.955.17 folder to Tax Return
 
REFRACT Lima 2019
REFRACT Lima 2019REFRACT Lima 2019
REFRACT Lima 2019
 
DNA Methylation in Young Women Breast Cancer
DNA Methylation in Young Women Breast CancerDNA Methylation in Young Women Breast Cancer
DNA Methylation in Young Women Breast Cancer
 
Ewings sarcoma management Chemotherapy trials
Ewings sarcoma management Chemotherapy trialsEwings sarcoma management Chemotherapy trials
Ewings sarcoma management Chemotherapy trials
 
Brain cancer
Brain cancerBrain cancer
Brain cancer
 
Swjcst comparison of risk factors and molecular analysis of right sided colon...
Swjcst comparison of risk factors and molecular analysis of right sided colon...Swjcst comparison of risk factors and molecular analysis of right sided colon...
Swjcst comparison of risk factors and molecular analysis of right sided colon...
 

Similaire à Head and neck pathology

Enfermedades causadas por priones
Enfermedades causadas por prionesEnfermedades causadas por priones
Enfermedades causadas por prionesCinthy Franco
 
Quiste mesenterico coledoco
Quiste mesenterico coledocoQuiste mesenterico coledoco
Quiste mesenterico coledocoNoé Morales
 
Cancer in Various Animals
Cancer in Various AnimalsCancer in Various Animals
Cancer in Various AnimalsAhlaina Worden
 
Does animal testing help human medicine
Does animal testing help human medicineDoes animal testing help human medicine
Does animal testing help human medicineAll Animal Rights
 
Mhe 2005 abstractbook_mherf.org
Mhe 2005 abstractbook_mherf.orgMhe 2005 abstractbook_mherf.org
Mhe 2005 abstractbook_mherf.orgzanamarques
 
Abdominal Radiology -Case conference September 6, 2017
Abdominal Radiology -Case conference September 6, 2017 Abdominal Radiology -Case conference September 6, 2017
Abdominal Radiology -Case conference September 6, 2017 Jayanth Hiremagalur
 
Sickle cell disease registry and prevalence of sickle cell disease in kenya b...
Sickle cell disease registry and prevalence of sickle cell disease in kenya b...Sickle cell disease registry and prevalence of sickle cell disease in kenya b...
Sickle cell disease registry and prevalence of sickle cell disease in kenya b...Kesho Conference
 
Overview of thyroid imaging
Overview of thyroid imagingOverview of thyroid imaging
Overview of thyroid imagingDurre Sabih
 
Matern.alfredo da costa
Matern.alfredo da costaMatern.alfredo da costa
Matern.alfredo da costafalcaoebarros
 
Approach to Adrenal Masses (Incidentaloma)
Approach to Adrenal Masses (Incidentaloma)Approach to Adrenal Masses (Incidentaloma)
Approach to Adrenal Masses (Incidentaloma)Elisha Rhode
 
Principles of cancer chemotherapy: a deep insight by RxVichuZ!
Principles of cancer chemotherapy: a deep insight by RxVichuZ!Principles of cancer chemotherapy: a deep insight by RxVichuZ!
Principles of cancer chemotherapy: a deep insight by RxVichuZ!RxVichuZ
 
Trial and Error Discover Neimark
Trial and Error Discover NeimarkTrial and Error Discover Neimark
Trial and Error Discover NeimarkJill Neimark
 
Pleural thickening 2009 janvol7issue1
Pleural thickening 2009 janvol7issue1Pleural thickening 2009 janvol7issue1
Pleural thickening 2009 janvol7issue1Dr Amolkumar W Diwan
 
Kim Solez Renal transplant pathology and future perspectives
Kim Solez Renal transplant pathology and future perspectivesKim Solez Renal transplant pathology and future perspectives
Kim Solez Renal transplant pathology and future perspectivesKim Solez ,
 
Kim Solez Renal transplant pathology and future perspectives
Kim Solez Renal transplant pathology and future perspectivesKim Solez Renal transplant pathology and future perspectives
Kim Solez Renal transplant pathology and future perspectivesKim Solez ,
 

Similaire à Head and neck pathology (20)

Enfermedades causadas por priones
Enfermedades causadas por prionesEnfermedades causadas por priones
Enfermedades causadas por priones
 
Quiste mesenterico coledoco
Quiste mesenterico coledocoQuiste mesenterico coledoco
Quiste mesenterico coledoco
 
Cancer in Various Animals
Cancer in Various AnimalsCancer in Various Animals
Cancer in Various Animals
 
Does animal testing help human medicine
Does animal testing help human medicineDoes animal testing help human medicine
Does animal testing help human medicine
 
tailgut cyst
tailgut cysttailgut cyst
tailgut cyst
 
Mhe 2005 abstractbook_mherf.org
Mhe 2005 abstractbook_mherf.orgMhe 2005 abstractbook_mherf.org
Mhe 2005 abstractbook_mherf.org
 
Abdominal Radiology -Case conference September 6, 2017
Abdominal Radiology -Case conference September 6, 2017 Abdominal Radiology -Case conference September 6, 2017
Abdominal Radiology -Case conference September 6, 2017
 
Sickle cell disease registry and prevalence of sickle cell disease in kenya b...
Sickle cell disease registry and prevalence of sickle cell disease in kenya b...Sickle cell disease registry and prevalence of sickle cell disease in kenya b...
Sickle cell disease registry and prevalence of sickle cell disease in kenya b...
 
Overview of thyroid imaging
Overview of thyroid imagingOverview of thyroid imaging
Overview of thyroid imaging
 
Matern.alfredo da costa
Matern.alfredo da costaMatern.alfredo da costa
Matern.alfredo da costa
 
Approach to Adrenal Masses (Incidentaloma)
Approach to Adrenal Masses (Incidentaloma)Approach to Adrenal Masses (Incidentaloma)
Approach to Adrenal Masses (Incidentaloma)
 
Cancer
Cancer Cancer
Cancer
 
Principles of cancer chemotherapy: a deep insight by RxVichuZ!
Principles of cancer chemotherapy: a deep insight by RxVichuZ!Principles of cancer chemotherapy: a deep insight by RxVichuZ!
Principles of cancer chemotherapy: a deep insight by RxVichuZ!
 
Trial and Error Discover Neimark
Trial and Error Discover NeimarkTrial and Error Discover Neimark
Trial and Error Discover Neimark
 
Progress in Clinical Neurosciences Vol 28, Chapter 1
Progress in Clinical Neurosciences Vol 28, Chapter 1Progress in Clinical Neurosciences Vol 28, Chapter 1
Progress in Clinical Neurosciences Vol 28, Chapter 1
 
Pleural thickening 2009 janvol7issue1
Pleural thickening 2009 janvol7issue1Pleural thickening 2009 janvol7issue1
Pleural thickening 2009 janvol7issue1
 
Kim Solez Renal transplant pathology and future perspectives
Kim Solez Renal transplant pathology and future perspectivesKim Solez Renal transplant pathology and future perspectives
Kim Solez Renal transplant pathology and future perspectives
 
Kim Solez Renal transplant pathology and future perspectives
Kim Solez Renal transplant pathology and future perspectivesKim Solez Renal transplant pathology and future perspectives
Kim Solez Renal transplant pathology and future perspectives
 
1543 2165%282004%29128-1279%3 apcsasc-2%2e0%2eco%3b2
1543 2165%282004%29128-1279%3 apcsasc-2%2e0%2eco%3b21543 2165%282004%29128-1279%3 apcsasc-2%2e0%2eco%3b2
1543 2165%282004%29128-1279%3 apcsasc-2%2e0%2eco%3b2
 
JAMESRWELLS CV
JAMESRWELLS CVJAMESRWELLS CV
JAMESRWELLS CV
 

Plus de Clinicas Quirurgicas (20)

Traumas y neoplasias anorectales
Traumas y neoplasias anorectalesTraumas y neoplasias anorectales
Traumas y neoplasias anorectales
 
Carotid body and nodal disease
Carotid body and nodal diseaseCarotid body and nodal disease
Carotid body and nodal disease
 
Appendicitis modi
Appendicitis modiAppendicitis modi
Appendicitis modi
 
Appendicitis modi
Appendicitis modiAppendicitis modi
Appendicitis modi
 
Expo clinicas neoplasias
Expo clinicas neoplasiasExpo clinicas neoplasias
Expo clinicas neoplasias
 
Clinicas quirurgicas expo
Clinicas quirurgicas expoClinicas quirurgicas expo
Clinicas quirurgicas expo
 
Benign breast disorders
Benign breast disordersBenign breast disorders
Benign breast disorders
 
Gallbladder & extrahepatic biliary tree
Gallbladder & extrahepatic biliary treeGallbladder & extrahepatic biliary tree
Gallbladder & extrahepatic biliary tree
 
Patologia pulmonar
Patologia pulmonarPatologia pulmonar
Patologia pulmonar
 
Hernias ingl
Hernias inglHernias ingl
Hernias ingl
 
Spleen
SpleenSpleen
Spleen
 
Spleen Trauma
Spleen TraumaSpleen Trauma
Spleen Trauma
 
Rectum and anus diseases
Rectum and anus diseasesRectum and anus diseases
Rectum and anus diseases
 
Gallbladder and biliary tract diseases
Gallbladder and biliary tract diseasesGallbladder and biliary tract diseases
Gallbladder and biliary tract diseases
 
Esophageal pathology
Esophageal pathologyEsophageal pathology
Esophageal pathology
 
Pancreatic Neoplasms
Pancreatic NeoplasmsPancreatic Neoplasms
Pancreatic Neoplasms
 
Acute abdomen
Acute abdomenAcute abdomen
Acute abdomen
 
Head and neck pathology
Head and neck pathologyHead and neck pathology
Head and neck pathology
 
Hernias
HerniasHernias
Hernias
 
Genitourinary tract trauma
Genitourinary tract traumaGenitourinary tract trauma
Genitourinary tract trauma
 

Dernier

Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...Sheetaleventcompany
 
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...Sheetaleventcompany
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...Sheetaleventcompany
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationMedicoseAcademics
 
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...Sheetaleventcompany
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxSwetaba Besh
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...amritaverma53
 
Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsCirculatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsMedicoseAcademics
 
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...gragneelam30
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana GuptaLifecare Centre
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Availableperfect solution
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...rajnisinghkjn
 
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...Sheetaleventcompany
 
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowChennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowtanudubay92
 
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Sheetaleventcompany
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableJanvi Singh
 
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Sheetaleventcompany
 
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Sheetaleventcompany
 
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryCall 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryJyoti singh
 

Dernier (20)

Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
 
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their Regulation
 
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
 
Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsCirculatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanisms
 
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
 
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
 
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowChennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
 
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
 
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
 
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
 
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryCall 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
 

Head and neck pathology