Acute Pharyngitis

Question 1

Most important agents causing pharyngitis

Answer 1

1) Viruses 2) GABHS

Question 2

Major virulence factor for GABHS

Answer 2

M protein

Question 3

Virulence factor of GABHS that facilitates resistance to phagocytosis by PMNs

Answer 3

M protein

Question 4

Prominent sore throat and fever in the absence of cough

Answer 4

Acute pharyngitis

Question 5

Pharynx is red, tonsils enlarged and clasically covered with a yellow blood-tinged exudate

Answer 5

Strep pharyngitis

Question 6

Petechiae or doughnut lesion on the soft palate and posterior pharynx

Answer 6

Strep pharyngitis

Question 7

Bacterial vs viral pharyngitis: Rapid onset

Answer 7

Bacterial

Question 8

Bacterial vs viral pharyngitis: Gradual onset

Answer 8

Viral

Question 9

Bacterial vs viral pharyngitis: Rhinorrhea, cough, diarrhea

Answer 9

Viral

Question 10

Bacterial vs viral pharyngitis: Concurrent conjunctivitis and fever

Answer 10

Viral, specifically adenovirus

Question 11

Bacterial vs viral pharyngitis: Small grayish vesicles and punched-out ulcers in the posterior pharynx

Answer 11

Viral, specifically Coxsackie herpangina

Question 12

Bacterial vs viral pharyngitis: Small yellowish-white nodules in the posterior phraynx

Answer 12

Viral, specifically Coxsackie acute lymphonodular pharyngitis

Question 13

Septic thrombophlebitis of the IJV with septic pulmonary emboli, producing hypoxia and pulmonary infiltrates

Answer 13

Lemierre syndrome

Question 14

Lemierre syndrome is a serious complication of

Answer 14

F. necrophorum pharyngitis

Question 15

Gold standard for diagnosing strep pharyngitis

Answer 15

Throat culture; an IMPERFECT gold standard

Question 16

T/F Rapid test to detect group A strep antigen is highly specific, so if a rapid test is positive, throat culture to diagnose strep pharyngitis is unnecessary and appropriate treatment is indicated

Answer 16

T

Question 17

T/F Most untreated episodes of strep pharyngitis resolve uneventfully in a few days

Answer 17

T

Question 18

T/F Early antibiotic therapy for strep pharyngitis hastens clinical recovery

Answer 18

T, by 12-24hrs

Question 19

Primary benefit of treatment of strep pharyngitis

Answer 19

Prevention of ARF

Question 20

Early antibiotic therapy for strep pharyngitis successfully prevents ARF if treatment is instituted within

Answer 20

9 days of illness

Question 21

T/F GABHS remains universally susceptible to Penicillin

Answer 21

T

Question 22

Treatment regimen most effective for eradication of streptococcal carriage

Answer 22

Clindamycin

Question 23

If compliance with antibiotic treatment for strep pharyngitis has been poor, ___ is suggested

Answer 23

IM benzathine penicillin

Question 24

Lowers incidence of pharyngitis for 1-2 yrs among children with recurrent culture-positive GABHS pharyngitis that has been severe and frequent

Answer 24

Tonsillectomy

Question 25

Frequent pharyngitis is defined as

Answer 25

> 7 episodes in a year, or >5 in EACH of the preceding 2 years

Question 26

T/F Viral respiratory infections can predispose to bacterial middle ear infections

Answer 26

T