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NURS 502 > Exam 1 - Tonsillopharyngitis > Flashcards

Exam 1 - Tonsillopharyngitis Flashcards

1
Q

Noninfectious causes of pharyngitis

A
  • Acid reflux
  • Postnasal drip from allergies
  • Canker sores
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2
Q

Infectious causes of pharyngitis: viral

A
  • EBV
  • Adenovirus
  • Rhinovirus
  • Parainfluenza
  • CMV
  • HSV
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3
Q

Infectious causes of pharyngitis: bacterial

A
  • Streptococcus (groups A, C, G)
  • Gonorrhea
  • Arcanobacterium haemolyticum
  • Fusobacterium necrophorum
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4
Q

Which form, bacterial or viral, is the MCC of infectious pharyngitis?

A

Viral

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5
Q

Viral pharyngitis symptoms

A
  • Afebrile or low grade temperature
  • Malaise
  • Fatigue
  • Rhinorrhea
  • Cough
  • Scratchiness in throat
  • Pain with swallowing
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6
Q

Viral pharyngitis physical exam findings

A

Pharynx mild erythema with little to no exudate

Absent painful/tender nodes

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7
Q

How would the provider manage a patient with viral pharyngitis?

A

Symptomatic management

  • Salt water gargles
  • Lozenges
  • Acetaminophen or ibuprofen
  • Hydration
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8
Q

When does viral pharyngitis typically resolve?

A

Resolves in 5-7 days

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9
Q

What is the incubation period of group a beta-hemolytic strep?

A

Incubation period of 2-5 days

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10
Q

How is group A beta-hemolytic strep transmitted?

A

Respiratory secretions

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11
Q

What age range is group A beta-hemolytic strep common?

A

Ages 5-15 years

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12
Q

Group A beta-hemolytic strep symptoms

A

Abrupt onset

  • Fever
  • Malaise
  • Headache
  • Lymphadenopathy
  • Dysphagia

Children: N/V, abdominal pain

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13
Q

Group A beta-hemolytic strep physical exam findings

A
  • Fine, sandpaper-like rash
  • Petechiae on soft palate
  • Circumoral pallor
  • Strawberry tongue
  • Odor
  • Pastia lines on skin (red lines in skin folds)
    • Begins to peel off after several days (not harmful)
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14
Q

What is the centor score used for?

A

Determining risk of group A beta-hemolytic strep

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15
Q

What is the centor criteria?

A
  • History of fever: +1
  • Tonsillar exudate: +1
  • Tender anterior cervical lymphadenopathy: +1
  • Absence of cough: +1
  • Age less than 15: +1
  • Age greater than 45: -1
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16
Q

What is the score breakdown for he centor criteria?

A

Score 0-1: low risk - don’t need rapid

Score 2-3: moderate risk - need rapid and treat if positive

Score 4-5: need rapid, treat if positive

Score 5+: treat empirically with antibiotics

17
Q

First line treatment for group A beta-hemolytic strep

A

PCN or amoxicillin

18
Q

What is second line treatment for gorup A beta hemolytic strep if the patient is allergic to PCN (non-type 1)?

A

If non-type 1 PCN allergy, cephalexin or cefadroxil

19
Q

If a patient has a type 1 PCN allergy, what could the provider prescribe for treatment of group A beta hemolytic strep?

A
  • Clindamycin
  • Azithromycin
  • Clarithromycin
20
Q

What is the usual course of treatment for group A beta hemolytic strep?

A

Treat for 10 days (5 days if using azithromycin)

21
Q

After starting antibiotic therapy to treat group A beta hemolytic strep, how long before patient begins to feel better?

A

24-48 hours

22
Q

What conditions would cause the provider to consider a tonsilectomy?

A

If patient has had 7+ episodes of sore throat in past year OR 5+ episodes of throat infections in past 2 years

23
Q

What causes acute bacterial rhinosinusitus?

A

Starts as viral upper respiratory infection

Mucus stagnates within sinuses causing bacterial growth

24
Q

Acute bacterial rhinosinusitis symptoms

A
  • URI for >10 days with no improvement or only improvement for short period and feeling worse again
  • Nasal obstruction/congestion
  • Purulent mucous drainage
  • Facial pain or pressure
25
Q

When do the most severe symptoms of acute bacterial rhinosinusitis appear?

A

Severe symptoms in first 3-4 days

Will feel pressure and fever

26
Q

How can the provider distinguish between a viral infection and bacterial infection (rhinosinusitis)?

A

Viral infection if symptoms <10 days, no fever

27
Q

Acute bacterial rhinosinusitis treatment

A

Augmentin

NURS 502 (43 decks)

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