Mouth: Pharyngitis

Question 1

Patient presents with fever, sore throat, and painful to swallow. On PE you note swollen cervical nodes. Dx?

Answer 1

Viral Pharnygitis (EBV)

Question 2

How do you confirm your Dx of viral pharyngitis?

Answer 2

Rapid strep test (and rapid influenze to R/O), do monospot test, exam abdomen for hepato/splenomegaly.

Question 3

How do you treat viral pharyngitis?

Answer 3

Tylenol/NSAIDS - NO ASPIRIN!

Question 4

Patient presents with fever, sore throat, and pain with swallowing. On PE you note swollen anterior cervical nodes. Dx?

Answer 4

Bacterial Pharyngitis

Question 5

How would you confirm your Dx or bacterial pharyngitis?

Answer 5

Rapid Strep test screening for GABHS - if negative. Culture for Group A streptococci.

Question 6

How would you treat bacterial pharyngitis?

Answer 6

Oral penicillin, amox, cefuroxime. If penicillin allergy can use Erythromycin.

Question 7

If bacterial pharyngitis goes untreated what are some possible complications?

Answer 7

Scarlet fever, glomerulophritis, and abscess formation.

Question 8

What are the 4 things you will need to see to confirm your Dx of Bacterial GABHS Pharyngitis?

Answer 8

Fever greater than 100.4, tender anterior cervical nodes, lack cough, and pharyngotonsillar exudate.