CAD-1 Sore Throat Flashcards
Covid Qs
ask about sick contact
test
Fever, malaise, chills, sweats
Severe SORE THROAT, fever, and Swollen lymph nodes
Mono (Ebstein Barr Virus- EBV)
PE shows Enlarged tonsils, Pharyngeal erythema and exudate, palatal petechiae, and tender POSTERIOR neck lymph nodes
Mono (EBV)
Large superficial shallow ulcers
CMV
What is CMV-Cytomegalovirus
Human Herpes Virus-5
mostly seen in immunocomp
CMV Primary infection
similar to Mono (fever, cough, myalgia, fatigue, arthralgia)
BUT no sore throat or swollen lymph nodes
Reactivation of CMV
Colitis- diarrhea, fever, abd pain
Retinitis- if CD4 <50, decreased vision and floaters
Esophagitis- LARGE SUPERFICIAL ULCERS on upper endoscopy
Pneumonitis
Neuro- brain swelling, Guillain Barre
What type of ulcers will you see w CMV?
Large superficial shallow ulcers in throat- or further down in esophagus
HSV1 causing Acute Herpetic Pharnygotonsillitis
Vesicles rupture
Ulcer lesions w grayish exudate remain
GAS
swollen ANTERIOR neck lymphnodes
No cough, Fever, often <15 yo
PTA- MUST NOT MISS
Severe unilateral sore throat
“hot potato” voice
Malaise, bad breath, drooling, ear pain
PE of Peritonsilar Abscess
Deviated uvula
Tender anterior lymph nodes
Neck pain
Fever
Evaluate w CT
Retropharyngeal abscess
this abscess is more medial
hx of eating chicken leg
or much younger patient
Drooling, Dysphagia, Distress
Epiglotittites
Tx: Rocephin
Cobblestone in Posterior throat
Postnasal drip
HEENT stuff to ask about when evaluating Sore Throat
HA Vision change Ear pain, hearing Congestion, PND, sinus pain Dysphagia, odynophagia, hoarse, dental problem
Cardiac
CP
Palpitations “heart racing”
Edema
Hypertension
Endocrine
Hot/cold sensitive
Tremor
Skin/air change
Abdomen PE- make sure to
check for SPLENOMEGALY and Epigastric region (GERD)
Labs to consider ordering
Covid
GAS rapid strep
CBC, CMP
Monospot
Tx of GAS
PCN
if allergy: Z pack, Clindamycin
Tx of PTA (Peritonsillar Abscess)
Clindamycin
