Infxn +Inflam Conditions Mouth + Throat

Question 1

Acute Pharyngitis

cause

Answer 1

Viral (MC) : Adenovirus (exudative w/ vesicle)
Rhinovirus, enterovirus,
epstein barr (exudative w/ vesicle)
Bacterial: group a Strep/S pyogenes

Question 2

Acute Pharyngitis

S/s

Answer 2

sore throat

Pain w/ swallowing + Speech

Question 3

Acute Pharyngitis

Tx

Answer 3

SYMPTOM : fluids, saline gargle, topical anaesthetics, NSAID
Antibio (strep) : Penicillin/Amoxi
(allergy - Clinda)

Question 4

Strep Phayryngitis

Sx

Answer 4

Fever (>38/100.4)
phyngotonsillar exudate
ANTERIOR cervical adenopathy
absence of cough

2-3 = culture
4-5 = antibiotics
or 2+ antibiotic

Question 5

Strep Pharyngitis

Complications

Answer 5

Rheumatic fever
Glomerulonephritis
Peritonsillar abscess

Question 6

Epliglottis

characteristics

Answer 6

less in kids (HiB vaccine)
DM
drooling, tripoding

Question 7

Epiglottitis

Dx

Answer 7

x ray - thumbprint

don’t try to visualize airway

Question 8

Epiglottitis

Tx

Answer 8

IV antibio (ceftizoxime/cefuroxime)
IV corticosteroid (dex)
THEN oral ABX/steroid taper
Intubation (rapid dyspnea)

Question 9

Laryngitis

cause

Answer 9

Infectious (MC)
V: Adenovirus, Rhinovirus, Flu, RSV, Parainfluenza
B: M. catarrhalis + Mycoplasma
singers - vocal

Question 10

Laryngitis

s/s

Answer 10

hoarseness
aphonia
pharyngitis/rhinitis/cough

Question 11

Laryngitis

Tx

Answer 11

SUPPORTIVE

rest, warm saline gargle, anesthetic, lozenge

Question 12

Oral Candidiasis

cause

Answer 12

Immunosuppression

Question 13

Oral Candidiasis

DX

Answer 13

white curd plaques on tongue
scrape off - red/blood
KOH prep

Question 14

Oral Candidiasis

Tx

Answer 14

nystatin
clotrimazole
fluconazole

Question 15

Oral Herpes Simplex/Cold Sore

cause

Answer 15

triggers: sun, smoking, fever, stress, hormone change

Question 16

Oral Herpes Simplex/Cold Sore

Dx

Answer 16

clinical
DNA
Tzanck Smear

Question 17

Oral Herpes Simplex/Cold Sore

Tx

Answer 17

Acyclovir,

Question 18

Acute laryngotracheobronchitis/Croup

characteristics

Answer 18

from *parainfluenza, fle, RSV, rhino, entero, myco
6 mos-6y/o
fall/winter

Question 19

Acute laryngotracheobronchitis/Croup

S/s

Answer 19

barking cough
inspiratory/expiratory stridor
horseness (laryngitis)
dyspnea

Question 20

Acute laryngotracheobronchitis/Croup

Dx

Answer 20

clinical
exclude FB +epiglottitis
dyspnea (night)
URI s/s
X-ray = steeple sign

Question 21

Acute laryngotracheobronchitis/Croup

Tx

Answer 21

Mild - cold air/dex
Moderate (mild respiratory distress) - dex , nebulizer epi
Severe- (marked distress) same above + admit

Question 22

Peritonsillar Abscess (Quinsy)

cause

Answer 22

tonsillitis –>cellulitis–>abscess
*strep pyogenes
staph aureus

Question 23

Peritonsillar Abscess (Quinsy)

s/s

Answer 23

hot potato voice
difficulty handling oral secretions
uvula deviation to opposite side
drooling
cocaine/meth/EtOH

Question 24

Peritonsillar Abscess (Quinsy)

Dx

Answer 24

CT

retro/parapharyngeal abscess, mono

Question 25

Peritonsillar Abscess (Quinsy)

Tx

Answer 25

ABX broad spectrum strep+ anearobe
ENT - I&D
tonsillectomy possible

Question 26

Parotitis

cause

Answer 26

clogged duct – inflam/infxn
DM
Sjorgren syndrome

Question 27

Sialadentitis

cause

Answer 27

Bact infxn of parotid/submandibular glands - S aureus

Question 28

Sialadentitis

S/s

Answer 28

acute pain/swelling near gland (w/ meals more)
tenderness, pus from duct
local pain, dysphagia, trismus
sudden onset

Question 29

Sialadentitis

Dx

Answer 29

CT scan

Question 30

Sialadentitis

Tx

Answer 30

sialologues (candy)
ABX: anti-staph
Dicloxacillin, amox-clav
rehydrate
pain meds
if no improvement - IENT

Question 31

Siadolithiasis

cause

Answer 31

hardened deposits in salivary gland duct system

salivary stagnation, ductal injury, gland inflam

Question 32

Siadolithiasis

S/s

Answer 32

colicky post-prandial pain + swelling

Question 33

Siadolithiasis

Tx

Answer 33

remove stone, massage, lemon drops

ABX staph