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ENT > Diseases of the throat > Flashcards

Diseases of the throat Flashcards

1
Q

who is commonly affected by acute throat infection

A 
children (5-10)
young people (15-25)
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2
Q

what is the common cause of acute throat infections

A

viral or bacteria:

  • common cold
  • influenza
  • strep
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3
Q

what are the symptoms of acute throat infections 

A

pain at the back of the mouth

physical irritation

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4
Q

what is the treatment of acute throat infections

A

self-limiting

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5
Q

if an acute throat infection + lethargy persists into a 2nd week what should you consider

A

mono/glandular fever

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6
Q

what is the common cause of tonsillitis

A

strep pyogens (aka group A beta haemolytic strep)

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7
Q

what is the Centor criteria

A

tonsillar exudate
tender anterior cervical lymph nodes
history of fever (>38)
absence of cough

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8
Q

what is the modified centor criteria

A 
tonsillar exudate 
tender anterior cervical lymph nodes 
history of fever (>38)
absence of cough 
<15 = + 1 point
>44 = -1 point
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9
Q

what is the fever PAIN criteria

A 
fever (In last 24hrs)
Purulence
Attend rapidly (getting worse)
Inflamed tonsils
No cough
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10
Q

when would you treat tonsillitis with antibiotics

A

fever pain = 4 or above

centor = 2 or 3 after culture, 4 or above without culture

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11
Q

what antibiotic is given in tonsillitis, for how long?

A

phenoxymethylpenicillin
clarithromycin if allergic

10 days

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12
Q

what 3 criteria are used to determine the severity of tonsillitis

A

Centor
Modified Centor
Fever PAIN

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13
Q

what are the complications of tonsillitis (3)

A

peritonsiliar abscess
rheumatic fever
glomerulonephritis

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14
Q

what causes a peritonsiliar abscess

A

bacteria between the muscle and tonsil which produces pus

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15
Q

when would a peritonsiliar abscess occur after tonsillitis

A

3-7 days

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16
Q

what are the symptoms of a peritonsiliar abscess

A

unilateral throat pain and odynophagia
lockjaw
displacement of tonsils and uvula
loss of concavity of palate

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17
Q

what is the treatment of a peritonsiliar abscess

A

drain + antibiotics

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18
Q

when would rheumatic fever occur after tonsillitis

A

3 weeks

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19
Q

what are the symptoms of rheumatic fever

A

fever
arthritis
pancreatitis

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20
Q

when would glomerulonephritis occur after tonsillitis

A

1-3 weeks after

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21
Q

what are the symptoms of glomerulonephritis

A

haematuria
albuminuria
oedema

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22
Q

what is acute tonsillitis also known as

A

adenotonsilitis

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23
Q

what is the cause of acute tonsillitis

A

usually viral:

  • EBV
  • rhinovirus
  • influenza/parainfluenza
  • enterovirus
  • adenovirus

30% bacterial

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24
Q

what is the treatment of acute tonsillitis

A

supportive

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25
Q

what is the treatment of recurrent acute tonsillitis

A

surgery

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26
Q

what are the symptoms of chronic tonsillitis

A 
chronic sore throat
bad breath
tonsilliths
peritonsillar erythema 
persistent cervical lymphadenopathy
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27
Q

what is the treatment of chronic tonsillitis

A

surgery (rarely offered)

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28
Q

what causes diphtheria

A

corynebaterium diphtheriae

29
Q

what does corynebaterium diphtheriae produce

A

an exotoxin which is cardio- and neuro-toxic

30
Q

what are the symptoms of diphtheria

A

severe sore throat

grey/white membrane across pharynx

31
Q

what is the treatment of diphtheria

A

vaccine
antitoxin + supportive
penicillin or erythromycin

32
Q

what type of vaccine is the diphtheria vaccine

A

toxoid vaccine

33
Q

what is infectious mononucleosis also known as

A

mono

glandular fever

34
Q

who is mainly affected by infectious mononucleosis

A

young adults

35
Q

what causes infectious mononucleosis

A

EBV

36
Q

what are the symptoms of infectious mononucleosis

A 
fever
enlarged lymph nodes
sore throat/pharynigitis/tonsillitis 
tired
jaundice/hepatitis 
palatal petechaiea haemorrhages = rash 
heptaosplenomegaly
37
Q

what are the investigations of infectious mononucleosis

A

EBV IgM = paul-bunell test/+ve monospot test (heterophile antibody test)
LFTs
FBC = low CRP, leucocytosis, atypical lymphocytes

38
Q

what is the treatment of infectious mononucleosis

A

self-limiting

severe + failing to improve = steroids

39
Q

why should ampicillin NOT be prescribed in infectious mononucleosis

A

generalised macular rash will develop

40
Q

what is the cause of candida

A

candida albicans

41
Q

who is at risk of candida

A

post-antibiotics
immunosuppressed
smokers
inhaled steroids (asthma)

42
Q

what are the symptoms of candida

A

white patches on red, raw mucous membrane in mouth or throat
pain

43
Q

when would you investigate candida

A

if recurrent

44
Q

what is the treatment of candida

A

1st line = nystatin

recurrent = fluconazole

45
Q

describe laryngeal polyps

A

unilateral and pedunculated

46
Q

describe laryngeal nodules

A

bilateral on middle 1/3 to posterior 1/3 vocal cords

47
Q

who is commonly affected by laryngeal nodules

A

young women

48
Q

what causes laryngeal nodules/polyps

A

change in laryngeal mucosa secondary to:

  • vocal abuse
  • infection
  • smoking
  • hypothyroidism (rare)
49
Q

what is a contact ulcer, where is it usually located

A

benign response to injury located in posterior vocal cord

50
Q

what causes contact ulcers

A

chronic throat clearing
voice abuse
GORD
intubation

51
Q

what is squamous papilloma

A

rare BENIGN tumour

52
Q

who is affected by squamous papilloma

A

<5

20-40

53
Q

what causes squamous papilloma

A

HPV 6

HPV 11

54
Q

what is squamous cell carcinoma

A

most common head and neck tumour

non-benign

55
Q

what are the risk factors for developing squamous cell carcinoma

A

smoking
drinking
HPV

56
Q

what is a paraganglioma

A

tumours arising in clusters of neuroendocrine cells dispersed throughout the body

57
Q

who is usually affected by paraganglioma

A

> 50

58
Q

what causes paragangliomas

A

MEN2

59
Q

what are the two types of paraganglioma

A

chromaffin positive

non-chromaffin

60
Q

where does a chromatin positive paraganglioma originate

A

nervous system

61
Q

what does a chromatin positive paraganglioma secrete

A

catecholamines

62
Q

what structures does a non-chromatin paraganglioma involve

A

carotid and aortic bodies
ganglia nodosum of vagus
clusters around oral cavity, nose, nasopharynx, larynx and orbit

63
Q

what causes epiglottitis

A

HiB

64
Q

what are the symptoms of epiglottitis

A

severe sore throat
drooling
fever
stridor

65
Q

what is the treatment of mild epiglottitis

A

supportive
antibiotic
nebulised adrenaline/saline
corticosteroids

66
Q

what is the treatment of severe epiglottitis

A

intubation and ventilation

67
Q

what are the symptoms of obstructive hyperplasia in the adenoid

A

hypo nasal voice
snoring
AOM/OME

68
Q

what are the symptoms of obstructive hyperplasia in the tonsils

A

muffled voice

snoring

ENT (6 decks)

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