ENT

Question 1

What bacteria causes pharyngitis at a rate similar to GABHS?

Answer 1

Fusobacterium necrophorum

Question 2

What is a complication of untreated fusobacterium necrophorum infection?

Answer 2

Lemierre syndrome (a life-threatening thrombophlebitis of internal jugular vein)

Question 3

Sensitivity of RAT (rapid antigen test for GABHS)?

Answer 3

80-90%

Question 4

A patient has centor score of 4

Answer 4

Empirically treat

Question 5

Patient has centor score of 0-1

Answer 5

No treatment or diagnostic test

Question 6

Patient has centor score of 2-3

Answer 6

Obtain RAT and treat if +

Question 7

What are the non-suppurative complications of GABHS?

Answer 7

1. RF
2. Strep toxic shock syndrome
3. PSGN
4. PANDAS (peds AI neuropsychiatric disorder AW GABHS)

Question 8

What are the suppurative complications of GABHS (the main reason we treat)?

Answer 8

1. Tonsillopharyngeal cellulitis
2. Peritonsillar and retropharyngeal abscess
3. Sinusitis
4. Meningitis
5. Brain abscess
6. Bacteremia

Question 9

DOC for GABHS pharyngitis?

Answer 9

PCN (can give a single IM shot of 600,000 units PCN G)

Question 10

What treatment might be indicated to reduce pain in GABHS pharyngitis?

Answer 10

A single dose of dexamethasone

Question 11

How can you differentiate a peritonsillar abscess from a retropharyngeal abscess?

Answer 11

Peritonsillar abscess will have trismus and uvula deviation where as a RP won’t. Neck films or CT are indicated for both.