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IPFC 2 Midterm 1 > ID- GAS pharyngitis > Flashcards

ID- GAS pharyngitis Flashcards

1
Q

What is acute pharyngitis?

A

Inflammation of mucous membranes of pharynx
- could +/- include tonsils for less than 2 weeks

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2
Q

What is the most common cause of acute pharyngitis (sore throat)? What is the bacteria that causes it?

A
  • virus

Group A strep

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3
Q

What are red flags for referral for GAS pharyngitis

A
  • progressive pain
  • unilateral throat pain
  • 14+ days of sore throat (should resolve in 1 week)
  • stiff neck
  • history of ARF/heart valve disease
  • Airway obstruction (stridor)
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4
Q

What are symptoms of Bacterial pharyngitis? When does it occur

A

GAS pharyngitis
occurs in winter or spring
- acute onset
- fever 38+
- mod-severe pain
- redness of pharynx
- swollen/tender lymph nodes

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5
Q

What are symptoms of Viral pharyngitis? When does it occur?

A

Viral Pharyngitis = all of bacteria +/- :
- cough
- diarrhea
- oral ulcers
- rhinorrhea (runny nose)
- conjunctivitis

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6
Q

Can you sufficiently differentiate between viral and bacterial through history/physical examination?

A

No

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7
Q

Why not culture every sore throat to see if GAS is present?

A

If you cultured every sore throat, you can detect GAS in people with viral sore throat and a harmless GAS colonizing in the throat does not need abx

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8
Q

When do you test for GAS?

A

When centor score is 3+

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9
Q

What are the testing steps for GAS for an adult?

A

Rapid antigen
- if not available use throat culture

ONLY USE 1

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10
Q

What are testing steps for GAS for a child

A

Rapid antigen
- if negative confirm with throat culture

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11
Q

When do you NOT do a throat swab in children even if their centor score is 3+?

A

If they present with a sore throat with
- cough
- rhinitis
- hoarseness

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12
Q

Why do we use antibiotics? What are false reasons?

A

Reduce risk of complications MAIN REASON
- suppurative and non-suppurative complications
Reduce symptomatology by 16 hours

Does not cure infection
Does not reduce spread

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13
Q

What are suppurative complications of GAS (3)

A

Characterized by pus, can lead to:
- sinusitis
- otitis media
- peritonsillar abscess

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14
Q

What are non-suppurative complications of GAS (2)

A

Acute rheumatic fever (can lead to heart disease and death)
- ABX can prevent this

Post-streptococcal glomerulo-nephritis
- ABX does not prevent this

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15
Q

How do you treat if the goal is to decrease symptoms

A
  • consider watchful waiting
    Start ABX if:
  • severe symptoms (centor 3+) not improved or worse after 2-3 days with watchful waiting
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16
Q

How do you treat if the goal is to prevent ARF? What are the risk factors of ARF

A

Treat if they have risk factors other than AGE
- local prevalence
- residence in indigenous community
- recent immigrant from developing country
- Previous ARF diagnosis

17
Q

What do you do if patient has a high risk for ARF but centor score is 2?

A

Throat swab

18
Q

What type of therapy is GAS

A

targeted therapy

19
Q

When should symptoms resolve

A

10 days

20
Q

What is the first line treatment choice for GAS? Requirement?

A

Penicillin V for 10 days
under 27kg = 300mg per dose 2-3 times/day
27kg+ = 600mg per dose 2-3 times/day

No personal history of IgE mediated hypersensitivity

or
Amoxicillin 50mg/kg

21
Q

What do you give for GAS if children expected to have a difficulty adhering to 10-day ABX

A

Penicillin G IM

22
Q

What do you give for GAS if children has a NON-anaphylactic type 1 reaction to penicillin

A

cephalexin 20mg/kg/dose BID

23
Q

What do you give for GAS if children has an ANAPHYLACTIC type 1 reaction?
what is the side effect?

A

Different side chain

24
Q

What is some symptomatic therapy you can give for pain with or without ABX?

A

Pain
- Dexamethasone 1 dose for
- tylenol or advil

Throat pain
- benzocaine

25
Q

How is GAS transmitted? What does this tell us?

A

Droplets, saliva, or nasal secretions

Testing close contacts not required

25
Q

Why do we give a 10 day treatment?

A

To prevent ARF complications

26
Q

How long should patients take antibiotic if fever and pain symptoms resolve

A

usually resolves in 7 days
- contact healthcare provider

IPFC 2 Midterm 1 (8 decks)

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