Adenotonsillar d/o

Question 1

inflammation of mucous membranes & submucosal structures of pharynx

Answer 1

pharyngitis

Question 2

most common viruses of pharyngitis (2)

Answer 2

rhinovirus and coronaviruses

Question 3

sx of fever, oral vesicles, lesions on hand, feet, butt or genitals; very contagious

Answer 3

coxsackie pharyngitis/hand foot and mouth dz

Question 4

4 reasons to tx GABHS

Answer 4

relief of sx
prevent rheumatic fever
prevent suppurative sequelae
reduce close contact transmission

Question 5

when to suspect GABHS

Answer 5

throat pain
fever
ANTERIOR cervical lymphadenopathy
edema/exudate
scarlatiniform rash
hx of GAS or close contact

Question 6

tx for GABHS (list 5 options)

Answer 6

PCN V for 10 days (amoxicillin for taste)
single dose IM PCN G
cephalosporin
azithromycin
clindamycin

Question 7

6 suppurative complications of GAS tonsillitis

Answer 7

peritonsillar abscess
retropharyngeal cellulitis, necrotizing fascitis
sinusitis, OM, mastoiditis
sepsis, meningitis
dehydration
acute airway obstruction

Question 8

3 non-suppurative, post strep sequelae

Answer 8

Rheumatic fever (pericarditis)
acute glomerulonephritis (hematuria–> renal failure)
strep toxic shock syndrome

Question 9

course of EBV sx

Answer 9

first is malaise, HA, low fever
then high fever, diffuse lymphadenopathy, tonsillitis w/ shaggy exudate, fatigue

Question 10

what does EBV look like?

Answer 10

** refer to ipad**

Question 11

how is EBV diagnosed (4)

Answer 11

clinical presentation
CBC (atypical T-lymph)
monospot test for heterophile Ig
EBV titers (IgM, early IGG)

Question 12

how is EBV tx

Answer 12

support
avoid contact sport—risk of splenomegaly
glucocorticoid in severe cases

Question 13

sx of odynophagia, posterior pharynx vesicles, fever 1-2 days, maculopapular eruption; mostly in young kids

Answer 13

enterovirus pharyngitis (herpangina)

Question 14

Centor criteria

Answer 14

Cant Cough
Exudate in tonsills
Nodes tender
Temp high
OR: young or old modifier

Question 15

hypertrophic d/o with difficulty breathing secondary to upper airway obstruction; no airflow >10 secs

Answer 15

OSA

Question 16

how is OSA tx

Answer 16

PAP (positive airway pressure)
mandibular advancement device if mild
wt loss
surgery

Question 17

STOP-BANG risk assessment for OSA

Answer 17

Snoring, Tired, Observed apnea, Pressure (HTN)
BMI, Age over 50, Neck circumference, Gender

Question 18

high risk STOP BANG score

Answer 18

over 3 yes

Question 19

3 indications for adenotonsillectomy (OIN)

Answer 19

Obstruction
Infection
Neoplasia

Question 20

most severe postoperative risk of adenotonsillectomy

Answer 20

hemorrhage 5-7 days later

Question 21

tx of recurrent strep tonsillitis

Answer 21

tonsillectomy

Question 22

how many strep tonsillitis a year do you need to consider it recurrent?

Answer 22

7 a yr
5 a yr for 2 yrs
3 a yr for 3 yrs

Question 23

3 most common organisms responsible for peritonsillar abscess

Answer 23

1 Group A strep (strep pyogenes)

Staph aureus, H. flu, Anaerobes

Question 24

sx of peritonsillar abscess

Answer 24

rapid development of unilateral pain, fever, lymphadenopathy
dysphagia & odynophagia
erythema of tonsils, bulging of soft palate
trismus
thick speech/hot potato voice

Question 25

6 tx of peritonsillar abscess

Answer 25

urgent otolaryngology consult
drainage or quinsy tonsillectomy
hydration & pain control
abx coverage w clindamycin
maybe steroids

Question 26

suppuration of retropharyngeal lymph nodes; urgent & mostly in kids

Answer 26

retropharyngeal abscess

Question 27

sx of retropharyngeal abscess (5)

Answer 27

dysphagia
drooling
torticollis
resp distress
voice change and neck swelling