module 4 peritonsillar abscess, pharyngitis

Question 1

peritonsillar abscess

Answer 1

accumulation of pus within the peritonsillar tissues between the tonsil and pharyngeal constrictor muscle
- deep infection of the head and neck

Question 2

peritonsillar abscess assoc. with

Answer 2

• pts hx of recurrent, chronic, or improperly treated tonsillitis
• blocked Weber glands

Question 3

weber glands

Answer 3

salivary glands located on the upper soft palate
- assist in removal of debris in tonsil area
infection secondary to poor oral hygiene, infections, smoking -> scarring -> blockage of the ducts
-> dec. removal of debris from tonsil area

Question 4

peritonsillar abscess usual bacteria

Answer 4

usually multiple
- most common: Group A streptococcus

Question 5

peritonsillar abscess clinical presentation

Answer 5

fever
chills
fatigue
malaise
halitosis
dysphagia
severe sore throat
otalgia
pain radiating to ear
drooling
hoarse voice

Question 6

peritonsillar abscess physical exam

Answer 6

appear acutely ill
trismus
marked edema and erythema of peritonsillar tissue and soft palate
- often fluctuant and covered with exudate
- almost always unilateral
- tonsil displaced downward and medially
- uvula edematous and displaced to opposite side
tender cervical adenopathy
tachycardia
drooling
dehydration

Question 7

peritonsillar abscess management

Answer 7

surgical intervention required
- needle aspiration, I&D, tonsillectomy
antibiotics
- clindamycin
steroids
hydration

Question 8

complications of peritonsillar abscess

Answer 8

airway obstruction
rupture of abscess -> serious sequelae
infection spreads
- involve superior constrictor muscle
- deep spaces of the neck
- mediastinum
necrosis of muscle may result
internal jugular vein thrombosis
-> septic pulmonary embolism
thrombophlebitis
chronic peritonsillar abscess
glottic edema
epiglottitis
septicemia
endocarditis
myocarditis
hemorrhage

Question 9

pharyngitis

Answer 9

inflammation of the pharynx from infection or irritation

Question 10

Causes of Non-infectious pharyngitis

Answer 10

referred pain
allergies
trauma from foreign bodies or burns
cancer
irritation
- dust, smoke, dryness, toxins

Question 11

causes of infectious pharyngitis

Answer 11

viruses: most common
- rhinovirus
bacteria: most common in peds
- streptococcus
fungi
parasies

Question 12

tonsillitis

Answer 12

acute or chronic inflammation of the tonsil

Question 13

noninfectious pharyngitis clinical presentation

Answer 13

ST and dryness
r/t environmental allergens:
- rhinorrhea
- watery eyes
- postnasal drip
r/t radiation/chemotherapy
- pain
- dryness
- dysphagia
- thrush

Question 14

viral pharyngitis clinical manifestations

Answer 14

sudden onset
- ST
- fever
- malaise
- cough
- HA
- myalgias
- fatigue
- rhinitis
- conjunctivitis (adenovirus)
- congestion
- cough with sputum production
mild erythema
little or no pharyngeal exudate
pharynx: swollen, boggy, or pale

Question 15

bacterial pharyngitis clinical manifestations

Answer 15

sudden onset
- ST
- painful swallowing
- fever
- chills
- HA
- N/V
- abdominal pain

Question 16

GAS pharyngitis physical exam

Answer 16

marked erythema of throat and tonsils
patchy, discrete, white or yellowish exudate
pharyngeal petechiae
tender anterior cervical adenopathy
PVS GAS exposure
- diffuse exanthem of scarlet fever (sand-paper rash)
- erythematous/strawberry tongue
- pressure on tonsillar pillars may produce purulent drainage
- uvual may be edematous

Question 17

pharyngitis management

Answer 17

viral: analgesic/antipyretic
Bacterial: symptomatic tx.
- GAS: antibiotic tx: PCN/amox

Question 18

complication of chronic tonsillitis

Answer 18

upper airway obstruction
sleep apnea
sleep disturbances

Question 19

suppurative complications of acute strep infection

Answer 19

streptococcal pharyngitis
otitis media
sinusitis
impetigo
pneumonia
necrotizing fasciitis

Question 20

nonsuppurative complications Assoc. with GAS

Answer 20

acute renal failure
poststreptococcal glomerulonephritis