Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Infectious Diseases > Pharyngitis > Flashcards

Pharyngitis Flashcards

1
Q

Pharyngitis is:

A

Inflammation in the back of the throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The most common cause of pharyngitis is:

A

Rhinovirus

lots of other viral infections (herpes, influenza, coronavirus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What % of pharyngitis cases are viral?

A

80-90% in adults, >70% in children

Antibiotics are OVERPRESCRIBED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If pharyngitis is viral, what can be done?

A

Usually self-limiting, treat symptoms if bothersome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most common bacteria involved in pharyngitis cases?

A

Group A Streptococci

Still self-limiting ! Not all bacterial cases need treatment

This is the only cause of sore throat that antibiotics are indicated for

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When do most cases of pharyngitis occur?

A

Colder months - Late winter, early psring

Respiratory disease season

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can we differentiate viral and bacterial pharyngitis?

GAS pharyngitis = Strep Throat

A

Modified Centor Score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does age affect the modified centor score?

A

3-14: +1
15-44: 0
45+: -1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some symptoms of pharyngitis that may suggest GAS infection?

Essentially Centor Score

A

Exudates, enlarged lymph nodes, N/V, scarlatinoform rash, fever, increased WBC’s

Also painful swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The 4 points contributing to the Centor score are:

A
  1. Exudate/swelling on tonsils
  2. Swollen anterior cervical nodes
  3. Temperature >38
  4. NO cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A score of -1 to 1 on the Centor score encourages this route of management:

A

Symptomatic treatment (No RADT, culture, or antibiotic needed)

-1 to 0 = 1-2.5% ; 1 = 5-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A score of 2 or 3 on the Centor Score encourages this route of management:

A

RADT or throat swab for culture - if positive for GAS, treat with antibiotics

2 = 11-17% ; 3 = 28-36%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A score of 4+ on the Centor Score encourages this route of management:

A

RADT or throat swab for culture - if positive, treat with antibiotics. Consider empiric antibiotics

4+ = 51-53%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

An advantage that a throat swab/culture has over RADT is:

A

Higher sensitivity (>90%)

RADT = 70-90% sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

An advantage that RADT has over a throat swab/culture is:

A

Takes minutes to complete

Throat swab/culture may take 1-2+ days to get results

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Antibiotic therapy started within ____ days of symptom onset hastened symptom improvement by ____ days for GAS.

A

2-3 days, 1-2 days

Continue to recommend symptomatic treatment

17
Q

Do antibiotics help reduce transmission rates of GAS?

A

Yes - 24 hours of abx therapy greatly reduced GAS from cultures.

18
Q

Are we concerned about complications from GAS?

A

No, incidence is low and there is not a lot of evidence for prevention

Includes peritonsillar abscess, lymph adenitis, OM, sinusitis, etc.

19
Q

An important reason to treat GAS is to prevent:

A

Rheumatic heart disease

Inflammatory response that destroys heart valves

Overall incidence = 0.3 per 100 000

20
Q

GAS must be treated within this amount of days to prevent RHD:

A

9 days of symptoms onset

21
Q

Which antibiotic is effective in preventing RHD?

A

Penicillin treatment

22
Q

This is also a complication related to GAS that cannot be prevented with antibiotics:

Kidney related - still uncommon

A

Acute post-strep glomerulonephritis

Majority of cases will improve without treatment

23
Q

What is the drug of choice for GAS treatment, and why?

A

Penicillin V - narrow spectrum AND prevents RHD

Also effective, safe, and cheap

24
Q

Optimal dosing of penicillin V for adults for GAS treatment is:

A

300mg TID or 600mg BID

25
Q

Optimal dosing of penicillin V for pediatrics for GAS treatment is:

A

40 mg/kg/day given BID or TID

26
Q

Duration of treament for GAS is:

A

10 days

NO Shorter for RHD prevention

27
Q

Can penicillin be taken with food?

A

Preferably on an empty stomach - drug is acid labile and food may impact absorption

CAN be given with food if nausea present

28
Q

If a patient has a true penicillin allergy, what antibiotic may be given for GAS treatment?

A

Macrolides: erythromycin, clarithromycin, or azithromycin

High rates of resistance…

29
Q

Can other beta-lactam agents be used for GAS treatment?

A

Yes, all have shown efficacy but do not have evidence of preventing RHD

29
Q

Which antibiotics could be used for 2nd line/treatment failure of GAS?

A

Cephalosporins (1st + 2nd gen)
Clindamycin
IM penicillin

Ceph = broader spectrum ; Clind = high resistance

30
Q

What is GAS carriage? Why is it problematic?

A

Some people carry GAS in the throat with no symptoms - does not require treatment. But difficult to separate from viral sore throat

Lots of carriers will be unnecessarily treated

31
Q

What can be given for symptomatic treatment for pharyngitis?

A

Oral/topical analgesics
Lozenges
Salt water gargles/fluids
Rest

Infectious Diseases (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions