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PHA 521 > MOUTH AND THROAT > Flashcards

MOUTH AND THROAT Flashcards

1
Q

Acute Pharyngitis

A

5-15% group A streptococcus

Mostly viral cause

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2
Q

Acute Pharyngitis: symptoms

A 
sore throat
fever
headache
malaise
"swollen glands"
URI symptoms
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3
Q

Acute Pharyngitis: physical exam findings

A 
pharyngeal erythema
tonsillar hypertrophy
purulent exudate
tender/enlarged anterior cervical lymph nodes
palatal petechiae
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4
Q

Acute Pharyngitis: diagnosis and treatment

A

diagnosis: exclude GABHS

treatment:
supportive
reassess in 5-7 d

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5
Q

Group A Beta Hemolytic Streptococcal Tonsillopharyngitis (GABHS): clinical presentation

A

sudden onset
tonsillar exudate
tender cervical adenitits
fever

rhinorrhea
cough absent

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6
Q

Centor Criteria

A

testing for GABHS

1, 4: don’t test
2, 3: test

Modified: age
(more likely in younger)

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7
Q

GABHS: diagnostics

A

rapid antigen detection testing

throat culture (for negative results)

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8
Q

GABHS: treatment

A

penicillin V 500 mg PO BID-TID x 10 days

more likely to see amoxicillin clinically

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9
Q

GABHS: complications

A

acute rheumatic fever
acute glomerulonephritis

…

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10
Q

Tonsillectomy Criteria

A

7+ episodes/year

5+episodes/year - 2 years

3+episodes/year - 3 years

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11
Q

Peritonsillar Abscess

A

most common deep neck infection in children, adolescents

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12
Q

Peritonsillar Abscess: etiology

A

polymicrobial - predominant species: streptococcus pyogenes (GABHS)

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13
Q

Peritonsillar Abscess: symptoms

A

severe sore throat
fever
muffled voice

drooling
trismus
neck swelling/pain
ipsilateral ear pain
fatigue, irritability, decreased PO intake
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14
Q

Peritonsillar Abscess: physical exam findings

A

swollen fluctuant tonsil
uvula deviation

fullness/bulging posterior soft palate

cervical LAD

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15
Q

Peritonsillar Abscess: treatment

A 
monitor for airway obstruction
drainage
antimicrobial therapy
supportive care
\+/- hospitalization
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16
Q

Acute Laryngitis: causes

A

infectious:

  • respiratory viruses
  • bacterial respiratory infections

non-infectious

  • vocal abuse
  • toxic exposure
  • GERD
  • trauma
  • vocal cord problems
17
Q

Laryngitis: clinical presentation

A

hoarseness

URI symptoms

18
Q

Laryngitis: treatment

A 
voice rest
treat underlying cause
humidification
hydration
avoid smoking

resolves in 1-3 weeks

19
Q

Epiglottitis: etiology

A

viral or BACTERIAL

Haemophilus influenza type B

streptococci
S. aureus

20
Q

Epiglottitis: risk factors

A

incomplete or non-vaccination

immunodeficiency

21
Q

Epiglottitis: clinical presentation

A 
fever
respiratory distress
anxiety
tripod/sniffing position
drooling
odynophagia
muffled speech 
stridor
22
Q

Epiglottitis: diagnosis

A

lateral plain radiograph - thumb sign (swollen epiglottis)

labs
direct laryngoscopy
fiberoptic nasolaryngoscopy

23
Q

Epiglottitis: treatment

A

medical emergency
airway protection
hospitalization
IV antibiotics

prevention: immunization

24
Q

Oral Herpes Simplex (HSV)

A

herpes simplex virus type 1

sudden onset
painful vesicular lesions on inflamed erythematous base

clinical diagnosis

triggers:

  • sunlight
  • fever
  • menstruation
  • stress
  • trauma
25
Q

HSV: treatment

A

antivirals
analgesics
fluid management

26
Q

Herpetic gingivostomatitis

A

primary HSV infection

ulcerative lesions (gingiva, mucus membranes of mouth)
perioral vesicular lesions
27
Q

Coxsackie virus

A

hand foot and mouth

most common in children

coxsackie A16

clinical diagnosis

supportive treatment (resolves 2-3d)

28
Q

Coxsackie virus: presentation

A

low grade fever
malaise
abdominal pain
URI symptoms

painful oral lesions (papules on erythematous base)

lesions on hand, feet, mouth, buttock

29
Q

Herpangina

A

vs handfootmouth:

  • higher fever
  • lesions more posterior (soft palate)

PHA 521 (12 decks)

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