ENT- throat diseases- sore throat and tonsils Flashcards
are the majority of cases of tonsillitis bacterial/viral ?
viral
which viruses can cause tonsillitis
influenza
parainfluenza
rhinovirus
enterovirus
adenovirus
what percentage of tonsillitis cases are bacterial
5-30%
what is the main cause of bacterial tonsillitis
strep. pyrogens (group a strep)
non-infectious causes of pharyngitis uncommon- what are they
physical irritation-
GORD
cigarette smoking
chronic irritation
how long does viral tonsillitis last
3-4 days
how long does bacterial tonsillitis last
~1 week- requires antibiotics to settle
what are the two scoring systems used to identify who would benefit from antibiotics for tonsillitis
FeverPain
Centor
Centor used to score tonsillitis- 1 point for each of what?
tonsillar exudate
tender anterior cervical lymph nodes
history of fever
absence of cough
FeverPain used to score tonsillitis- 1 point for each of what?
purulence
attend rapidly (within 3 days)
very inflamed tonsils
no cough
If sore throat and lethargy with tonsilliti persist into the second week, especially if the person is 15-25 years of age, consider what?
glandular fever
what is the first line antibiotic for tonsillitis
penicillin (clarithromycin if allergic)
what are the possible complications of tonsillitis
otitis media- most common
peritonsillar abscess (quincy)
parapharyngeal abscess
epiglottis
lemierre syndrome
what are possible late complications of tonsillitis
rheumatic fever- fever, arthritis, pancarditis, 3 weeks post sore throat
glomurelonephritis- haematuria, albuminurea, oedema 1-3 weeks post sore throat
what are the clinical features of quinsy
unilateral throat pain and odynophagia
thismus (difficulty opening mouth)
3-7 days preceding tonsillitis
medial displacement of tonsils and uvula
hot potato voice
Concavity of palate lost
how do you manage quinsy
aspiration and IV antibiotics
neutropenia can cause a sore throat true/false?
true
what drugs can cause neutropenia
DMARDs
carbimazole
chemotherapy
which virus causes glandular fever
epstein-barr virus
which family is EBV apart of
herpes family
which triad often occurs in patients with glandular fever
fever
pharyngitis
lymphadenopathy
patients with glandular fever should avoid sports for 6 weeks due to what risk
splenic rupture
what are some possible complications of glandular fever
splenic rupture
lymphoma, especially immunocompromised
upper airway obstruction
anaemia, thrombocytopenia
what is the larynx aka
the voice box
causes of laryngeal nodules and polyps
voice abuse
smoking
infection
what are laryngeal nodules and polyps rarely associated with
hypothyroidism
where are laryngeal nodules usually located and who is most likely to get them
located bilaterally on middle 1/3 to posterior 1/3 of the vocal box
young women most likely
are laryngeal polyps located bilaterally/unilaterally
unilaterally
what are the clinical features seen in laryngeal nodules and polyps
voice changes- hoarseness, raspy
pain
frequent coughing/throat clearing
what is reinkes oedema
swelling of the vocal cords due to fluid collected within the reinkes space
what is the most common cause of reinkes oedema
smoking
what are the clinical features seen in reinkes oedema
hoarse voice
dysphonia
throat discomfort
what investigation is used to diagnose reinkes oedema
laryngoscopy
what is the most common cause of obstructive sleep apnoea in children
adenotonsilar hypertrophy
in diagnosing glandular fever, what might be seen on blood film?
atypical lymphocytes
