Epiglottitis Flashcards

1
Q

The epiglottis is a soft flap of tissue that sits beneath the tongue at the back of the throat. When we swallow this closes the airway so we do not aspirate food or drink into the lungs. Epiglottitis is when the epiglottis becomes inflamed. Is epiglottitis dangerous?

A
  • yes

This is a life-threatening medical emergency characterised by inflammation of the epiglottis and surrounding supraglottic structures.

Causes rapid airway obstruction

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2
Q

The epiglottis is anchored to the base of the tongue and what?

1 - vocal cords
2 - trachea
3 - anterior rim of the thyroid cartilage
4 - oesophagus

A

3 - anterior rim of the thyroid cartilage

Epiglottitis causes inflammation and enlarged epiglottis and surrounding tissues, including supraglottic structures

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3
Q

Is epiglottitis more commonly seen in adults or infants?

A
  • infants

Can affect any age, but most common in 2-7 y/o

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4
Q

What is the incidence of epiglottitis?

1 - 2 per 100,000
2 - 200 per 100,000
3 - 2000 per 100,000
4 - 20,000 per 100,000

A

1 - 2 per 100,000

Affects males and females equally

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5
Q

Which of the following is the most common cause of epiglottitis?

1 - foreign body
2 - iatrogenic
3 - bacterial infection
4 - viral infection

A

3 - bacterial infection

Viral and fungal infections, as well as non-infectious causes like thermal injury, can also contribute to the development of acute epiglottitis.

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6
Q

Bacterial infection is the most common cause of epiglottitis. All of the following bacteria can cause epiglottitis, but which is the most common cause?

1 - Haemophilus influenzae type B
2 - Streptococcus pneumoniae
3 - Group A Streptococci
4 - Staphylococcus aureus

A

1 - Haemophilus influenzae type B

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7
Q

Vaccination has reduced the incidence of epiglottitis. Which vaccine is responsible for this?

1 - Men B vaccine
2 - PCV vaccine
3 - Rotovirus vaccine
4 - Hib vaccine

A

4 - Hib vaccine

Hib = Haemophilus influenzae type B vaccine

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8
Q

The symptoms of epiglottitis can vary, but typically is the presentation of symptoms insidious in onset or a rapid onset?

A
  • rapid onset
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9
Q

All of the following are symptoms of epiglottitis, except which one?

1 - severe sore throat
2 - odynophagia (painful swallowing
3 - reduced saliva as difficult to swallow
4 - muffled voice or ‘hot potato’ voice different from normal voice (voice cords affected)
4 - stridor (high-pitched, inspiratory noise)
5 - respiratory distress (tachypnea)
6 - fever (high-grade typically = bacterial cause)
7 - tripod or sniffing position

A

3 - reduced saliva as difficult to swallow

Typically causes drooling due to difficulty handling secretions

Remember 4 Ds:

  • drooling
  • dhysphagia
  • dysphonia (voice changes)
  • distress when breathing
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10
Q

If epiglottitis is suspected, which of the following should not be performed routinely?

1 - throat inspection
2 - chest X-ray
3 - fundoscopy
4 - blood sample

A

1 - throat inspection

Should only be performed by ENT doctor for risk of airway obstruction

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11
Q

All of the following can be used when diagnosing epiglottitis, but which is the most useful?

1 - Lateral neck radiograph (‘thumb sign’)
2 - Flexible fiberoptic laryngoscopy (ENT only)
3 - Blood cultures and throat swabs
4 - Clinical diagnosis

A

4 - Clinical diagnosis

Physical examination and history

Flexible fiberoptic laryngoscopy (ENT only) will show a cherry red epiglottis

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12
Q

When treating a patient with suspected epiglottitis, if they require an endotracheal intubation or emergent tracheostomy in A&E or ICU?

A
  • ICU

Must be monitored closley

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13
Q

Should antibiotics be prescribed in epiglottitis?

A
  • Yes

Cephalosporins is commonly used (Cephalexin, Ceftriaxone, Ceftazidime, Cefuroxime)

Typically caused by the bacteria Haemophilus influenza type B vaccine, so empirical broad spectrum antibiotics should be given

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14
Q

In addition to antibiotics and potential intubation, which of the following is NOT routinely performed in a patient with suspected epiglottitis?

1 - corticosteroids
2 - analgesia
3 - fluids
4 - antihistamines

A

1 - corticosteroids

Rarely given, and if so this is on a case to case basis

Patients must also be closely monitored and followed up

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15
Q

What is the best treatment/prevention for epiglottitis?

1 - hand sanitisation
2 - Hib vaccine
3 - mask wearing
4 - remaining at home when sick

A

2 - Hib vaccine

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