Infxn +Inflam Conditions Mouth + Throat Flashcards
Acute Pharyngitis
cause
Viral (MC) : Adenovirus (exudative w/ vesicle)
Rhinovirus, enterovirus,
epstein barr (exudative w/ vesicle)
Bacterial: group a Strep/S pyogenes
Acute Pharyngitis
S/s
sore throat
Pain w/ swallowing + Speech
Acute Pharyngitis
Tx
SYMPTOM : fluids, saline gargle, topical anaesthetics, NSAID
Antibio (strep) : Penicillin/Amoxi
(allergy - Clinda)
Strep Phayryngitis
Sx
Fever (>38/100.4)
phyngotonsillar exudate
ANTERIOR cervical adenopathy
absence of cough
2-3 = culture
4-5 = antibiotics
or 2+ antibiotic
Strep Pharyngitis
Complications
Rheumatic fever
Glomerulonephritis
Peritonsillar abscess
Epliglottis
characteristics
less in kids (HiB vaccine)
DM
drooling, tripoding
Epiglottitis
Dx
x ray - thumbprint
don’t try to visualize airway
Epiglottitis
Tx
IV antibio (ceftizoxime/cefuroxime)
IV corticosteroid (dex)
THEN oral ABX/steroid taper
Intubation (rapid dyspnea)
Laryngitis
cause
Infectious (MC)
V: Adenovirus, Rhinovirus, Flu, RSV, Parainfluenza
B: M. catarrhalis + Mycoplasma
singers - vocal
Laryngitis
s/s
hoarseness
aphonia
pharyngitis/rhinitis/cough
Laryngitis
Tx
SUPPORTIVE
rest, warm saline gargle, anesthetic, lozenge
Oral Candidiasis
cause
Immunosuppression
Oral Candidiasis
DX
white curd plaques on tongue
scrape off - red/blood
KOH prep
Oral Candidiasis
Tx
nystatin
clotrimazole
fluconazole
Oral Herpes Simplex/Cold Sore
cause
triggers: sun, smoking, fever, stress, hormone change
Oral Herpes Simplex/Cold Sore
Dx
clinical
DNA
Tzanck Smear
Oral Herpes Simplex/Cold Sore
Tx
Acyclovir,
Acute laryngotracheobronchitis/Croup
characteristics
from *parainfluenza, fle, RSV, rhino, entero, myco
6 mos-6y/o
fall/winter
Acute laryngotracheobronchitis/Croup
S/s
barking cough
inspiratory/expiratory stridor
horseness (laryngitis)
dyspnea
Acute laryngotracheobronchitis/Croup
Dx
clinical exclude FB +epiglottitis dyspnea (night) URI s/s X-ray = steeple sign
Acute laryngotracheobronchitis/Croup
Tx
Mild - cold air/dex
Moderate (mild respiratory distress) - dex , nebulizer epi
Severe- (marked distress) same above + admit
Peritonsillar Abscess (Quinsy)
cause
tonsillitis –>cellulitis–>abscess
*strep pyogenes
staph aureus
Peritonsillar Abscess (Quinsy)
s/s
hot potato voice difficulty handling oral secretions uvula deviation to opposite side drooling cocaine/meth/EtOH
Peritonsillar Abscess (Quinsy)
Dx
CT
retro/parapharyngeal abscess, mono
Peritonsillar Abscess (Quinsy)
Tx
ABX broad spectrum strep+ anearobe
ENT - I&D
tonsillectomy possible
Parotitis
cause
clogged duct – inflam/infxn
DM
Sjorgren syndrome
Sialadentitis
cause
Bact infxn of parotid/submandibular glands - S aureus
Sialadentitis
S/s
acute pain/swelling near gland (w/ meals more)
tenderness, pus from duct
local pain, dysphagia, trismus
sudden onset
Sialadentitis
Dx
CT scan
Sialadentitis
Tx
sialologues (candy) ABX: anti-staph Dicloxacillin, amox-clav rehydrate pain meds if no improvement - IENT
Siadolithiasis
cause
hardened deposits in salivary gland duct system
salivary stagnation, ductal injury, gland inflam
Siadolithiasis
S/s
colicky post-prandial pain + swelling
Siadolithiasis
Tx
remove stone, massage, lemon drops
ABX staph
