L 10 Flashcards
Order from top to bottom the phyraynex
nasopharynx, oropharynx, larynx, esophagus
What is Pharyngitis? causes and epidemiology?
- Inflammation of the throat
- Caused by: viruses (e.g rhinovirus)
- Spread through direct contact of secretions
Acute sore throat most likely cause
70-90% = viral infection
Strep, glandular fever, trauma, medicines, carcinoma
Viral vs bacterial sore throat:
Age: Viral = any age, bacterial = mainly school aged
Duration: Viral AND bacterial =both 3-7 days
Cough present? Viral = common, bacterial = rare
Fever: Viral: low-grade fever, headache, but bacterial = high-grade fever
Referral of sore throat:
- Duration over 2 weeks
- High temp + swollen glands + tonsillar exudate
- Dysphagia or dysphonia (hoarse voice)
- Higher risk demographic groups (e.g māori and pacific people)
Most common or sore throats are viral or bacterial?
More than 30% or cases are viral but 72-90% patients are prescribed antibiotics.
Are antibiotics necessary for sore throats?
No, unless there are rheumatic fever complications
If a sore throat is of bacterial origin, should antibiotics be prescribed?
Not really, the immune system should clear it within a few days automatically anyway. If ongoing or serious then yes.
What is the reason for prescribing antibiotics for sore throat?
Reduce the risk of complications Diagnostic uncertainty Patients expects to be prescribed antibiotics Reduce duration of symptoms Reduce pain
Untreated sore throat bacteria can lead to further complications how many weeks after a
Untreated GAS bacteria can lead to rheumatic fever 1-5 weeks after a sore throat
Rheumatic fever can causes
Inflammation of heart, joints, brain and skin, and can causing scarring of heart valves (rheumatic heart disease)
What can we do if causing scarring of heart valves?
Heart valve replacement surgery
Rheumatic heart disease is more prevalent in … populations
30 times more prevalent is Māori and 40 times more prevalent are pacific
Antibiotics GUIDELINES are recommended for sore throat IF:
A person is at a high risk of rheumatic fever i.e:
- Family/personal/household history
- Māori and pacific ethnicity
- Living in crowded circumstances or in lower SES areas
- And aged 3-35
Or if other severe symptoms were present.
WHat is the Process of applying antibiotics for RF?
High risk patients = throat swab taken first and begin empiric antibiotics therapy . When swab test returns, patients who test negative for GAS can discontinue antibiotic use.
Which antibiotics Likely to be prescribed for a GAS sore throat (x4). Course duration =
Penicillin v for 10 days
Amoxicillin for 10 days
If allergic to penicillins:
Erythromycin, roxithromycin for 10 days