oropharynx triggers Flashcards
white/purple exudates in oropharynx with fever, HA and posterior cervical LAD
Mono/EBV
posterior cervical LAD
mono/EBV
splenomegaly
mono/EBV
rash caused by ampicillin or amoxicillin
Mono/EBV
small vesicles on soft palate and uvula that rupture to form shallow white ulcers
coxasackievirus
vesicles on hard palate and tongue
HSV infection
sore throat, fever, conjunctivitis, post auricular adenopathy
adenovirus
sore throat, fever, myalgias, headache, cough
influenza
any chief complaint of sore throat should always recieve
rapid antigen detection test (strep)
what does monospot look for
heterophile antibodies
what population shows high false negatives with the monospot test
children less than 4 years of age
what lab values are seen in mono
lymphocytosis
elevated LFTs
oral prednisone for significant tonsilar swelling, advised to avoid contact sports for 4 weeks. antivirals not reccomended
EBV/mono
No cough
strep
tonsillar exudates, anterior cervical LAD, fever, sore throat
strep throat (GABHS)
rash looking like sunburn with sandpaper consitiency
scarlet fever (GABHS)
also presents with strawberry tongue and palatal petechiae
PCN VK, PCN G, Amox.
keflex if allergy
azithro/clinda last resort
strep throat
otitis media is seen as a complication to which diagnosis
strep throat
complications of this diagnosis include:
glomerulonephritis
vlavular heart disease
rheumatic fever
strep throat
what lab finding is elevate after a recent strep infection
Antistreptolysin O titer
MC microbes are strep pyogenes and staph aureus
peritonsillar abscess
presents with unilateral sore throat with referred ear pain, fatigue, irritability and neck swelling
peritonsilar abscess
presents with muffled voice, trouble swallowing and drooling.
also with unilateral sore throat
peritonsillar abscess
deviation of the uvula to the right side suggests what diagnosis? what side is the affected side?
peritonsillar abscess to the left tonsil
CT v IV contrast
peritonsillar abscess -
not necessary for DX but checks for complications!
also retropharyngeal abscess -
ring enhancing lesion
Ludwigs angina - assess extent
lateral neck radiograph, what is it used for??
used in peritonsillar abscess to r/o epiglottitis or retropharyngeal abscesses
IV Unasyn or clindamycin. if patient does not respond promptly, add Vanc.
Peritonsillar abscess
after IV is done, do 14 days of oral such as Augmentin or clinda.
if MRSA use oral clinda or linezolid
patient presents with trouble and pain with swallowing with associated neck swelling, stiffness and LAD
Retropharyngeal abscess
IV:
Unasyn
rocephin + metro
Clinda + levo
retropharyngeal abscess
continue IV until afebrile then transfer to PO metro or levo
Also exact formulas used to treat ludwigs angina
exudative tonillopharyngitis with fever and cervical LAD
bacterial Laryngitis
MCC is GABHS, Diptheria, M Cat
acute laryngitis
can be given oral steroids or erythromycin to aid in speedy recover
actors/singers with acute laryngitis
PCN, eryththromycin
bacterial laryngitis
how do you treat GERD as a cause of laryngitis
Proton pump inhibitor
acute laryngeal and subglottic swelling
croup
MCC is parainfluenza 1 & 3
croup
barking, seal like cough
croup
inspiratory stridor
croup
use of accessory respiratory muscles (retractions)
croup
Xray shows steeple sign (subglottic narrowing)
croup
if a patient has a barky cough and a hoarse cry, but lacks chest wall retractions and stridor, what is their diagnosis
MILD croup
treated with dexamethasone shot and oral prednisone
treatment for outpatient croup
dexamethasone and nebulized epi
moderate to severe croup
stridor at rest with mild-moderate retractions
moderate croup
stridor at rest, marked retractions with agitations, lethargy and cyanosis
severe croup
complication of bacterial tracheitis
croup
cellulitis of supraglottitis and surrounding structures
epiglottitis
MC caused by H flu type B
epiglottitis
tripod position
epiglottitis
dysphagia, drooling, distress and odynophagia out of proportion to PE findings
epiglottitis
confirmed diagnosis with laryngoscopy
epiglottitis
Xray showing thumbprint sign
epiglottitis
note: Xray is only obtained if pt is stable and you are trying to differentiate from croup which shows the CHURCH steeple sign (Church-Croup)
rocephin + van
Rocephin + clinda
PCN allergy = van + flouroquinolone
epiglottitis
arises from infected or recently extracted tooth 2/3 of the time
ludwigs angina
a patient presents with firm textured skin on the floor of his mouth that has progressively resulted in bilateral swelling in the sublingual and submaxillary area. no LAD is noted
ludwigs angina
strep viridans is MCC
ludwigs angina after 2nd/3rd molar infection post extraction
what is considered an emergency in ludwigs angina
deep neck masses
inspiratory stridor, aside from Croup, is seen when?
bilateral vocal cord paralysis
when would it be recommmeneded to remove tonsils
- obstructive sleep apnea
- recurrent throat infections (>3 episodes in each of 3 years, >5 in each of 2, >7 in 1 year)
noted w tongue displacement
ludwigs angina
damage or lesion to the recurrent laryngeal nerve results in..
vocal cord paralysis
peritonsillar abscess s/s
D THORN “it feels like i have D THORN stuck in there”
se:
Drooling
trismus
hot potato voice
refferred ear pain
neck swelling and pain
diptheria
bacterial laryngitis
treated with PAN/erythromycin cuz remeber you dip your pen in blood