Mouth and Throat 2.27.18 Flashcards
(41 cards)
Name the 5 centor criteria
For RADT - strept throat
- Sudden onset
- Tonsillar exudate
- Tender lymph nodes
- Fever
- NO COUGH
What is the treatment for bacterial tonsillitis?
Penicillin V 500mg BID-TID for 10 days
or Amoxicillin
If PCN allergic: Macrolides: Azithromycin, erythromycin, clarithromycin
Name 4 complications of strep throat
- Acute rheumatic fever*
- Acute glomerulonephritis*
- Mastoiditis
- Bacteremia
How many times does someone need to have tonsillitis to have tosillectomy
7 in a year
5 a year, for 2 consecutive years
3 a year for 3 consecutive years
What constitutes an episode of strept throat?
- Strept throat
- Fever >100.9
- Tonsillar exudate
- Anterior cervical adenopathy
- Confirmed GABHS culture
Most common cause of acute pharyngitis?
Viral
Most common bacterial cause of acute pharyngitis?
Group A strept
What organism most common causes peritonsillar abcess?
streptococcus pyogenes (GABHS)
Name 5 symptoms of peritonsillar abcess
- hot potato voice
- drooling
- Trismus (lock jaw)
- fever
- exudate
Best imaging for Peritonsillar abcess
CT with IV constrast
Peritonsillar abcess: treatment
Ampicillin-sulbactam IV (or clindamycin)
-or-
Amoxicillin-clavaulanate for 14 days (or clindamycin)
After when do you become concerned about laryngitis?
If it hasn’t resolved by 3 weeks they need to see ENT and have imaging
Epiglottitis: cause
Haemophilus influenzae type B (bacterial)
What are the 3 D’s of epiglottitis?
Dysphagia - “pain out of proportion”’
Distress - anxiety, can’t breathe well
Drooling - too painful to swallow
What is thumb sign?
inflammed epiglottis on lateral radiograph
What is the treatment (ABO) for epiglottitis?
3rd generation cephalosporin + Vancomycin IV
+/- Dexamethasone
What virus causes oral herpes?
Herpes Simplex Virus type 1
What causes Hand, Foot, Mouth disease?
coxsackie A16
What is the difference in lesions between oral herpes and coxsackie?
herpes: painful vesicles on erythematous base
coxsackie: papules on erythematous base
Compare and contrast fever and location of papules: Herpangia and Hand, Foot, Mouth
HFM:
- lower fever
- papules on tongue and hard palate (more anterior)
Herpangia:
- HIGHER fever
- lesions on soft palate (more posterior)
What virus causes apthous ulcers?
Herpes-virus 6
Treatment for apthous ulcers?
steroids + analgesics
Bechet’s Dx criteria
recurrent oral ulcers more than 3 times/year + 2 of the following [recurrent genital ulcers, eye lesions, skin lesions]
What other labs need to be considered with a patient with thrush?
- HIV
2. blood glucose
