MOUTH AND THROAT Flashcards
Acute Pharyngitis
5-15% group A streptococcus
Mostly viral cause
Acute Pharyngitis: symptoms
sore throat fever headache malaise "swollen glands" URI symptoms
Acute Pharyngitis: physical exam findings
pharyngeal erythema tonsillar hypertrophy purulent exudate tender/enlarged anterior cervical lymph nodes palatal petechiae
Acute Pharyngitis: diagnosis and treatment
diagnosis: exclude GABHS
treatment:
supportive
reassess in 5-7 d
Group A Beta Hemolytic Streptococcal Tonsillopharyngitis (GABHS): clinical presentation
sudden onset
tonsillar exudate
tender cervical adenitits
fever
rhinorrhea
cough absent
Centor Criteria
testing for GABHS
1, 4: don’t test
2, 3: test
Modified: age
(more likely in younger)
GABHS: diagnostics
rapid antigen detection testing
throat culture (for negative results)
GABHS: treatment
penicillin V 500 mg PO BID-TID x 10 days
more likely to see amoxicillin clinically
GABHS: complications
acute rheumatic fever
acute glomerulonephritis
…
Tonsillectomy Criteria
7+ episodes/year
5+episodes/year - 2 years
3+episodes/year - 3 years
Peritonsillar Abscess
most common deep neck infection in children, adolescents
Peritonsillar Abscess: etiology
polymicrobial - predominant species: streptococcus pyogenes (GABHS)
Peritonsillar Abscess: symptoms
severe sore throat
fever
muffled voice
drooling trismus neck swelling/pain ipsilateral ear pain fatigue, irritability, decreased PO intake
Peritonsillar Abscess: physical exam findings
swollen fluctuant tonsil
uvula deviation
fullness/bulging posterior soft palate
cervical LAD
Peritonsillar Abscess: treatment
monitor for airway obstruction drainage antimicrobial therapy supportive care \+/- hospitalization
Acute Laryngitis: causes
infectious:
- respiratory viruses
- bacterial respiratory infections
non-infectious
- vocal abuse
- toxic exposure
- GERD
- trauma
- vocal cord problems
Laryngitis: clinical presentation
hoarseness
URI symptoms
Laryngitis: treatment
voice rest treat underlying cause humidification hydration avoid smoking
resolves in 1-3 weeks
Epiglottitis: etiology
viral or BACTERIAL
Haemophilus influenza type B
streptococci
S. aureus
Epiglottitis: risk factors
incomplete or non-vaccination
immunodeficiency
Epiglottitis: clinical presentation
fever respiratory distress anxiety tripod/sniffing position drooling odynophagia muffled speech stridor
Epiglottitis: diagnosis
lateral plain radiograph - thumb sign (swollen epiglottis)
labs
direct laryngoscopy
fiberoptic nasolaryngoscopy
Epiglottitis: treatment
medical emergency
airway protection
hospitalization
IV antibiotics
prevention: immunization
Oral Herpes Simplex (HSV)
herpes simplex virus type 1
sudden onset
painful vesicular lesions on inflamed erythematous base
clinical diagnosis
triggers:
- sunlight
- fever
- menstruation
- stress
- trauma
