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Clin Med I - ENT > Pharyngitis > Flashcards

Pharyngitis Flashcards

1
Q

Where is pharyngitis inflammation is located?

Where is tonsillitis located?

A
  • posterior oral cavity (between tonsils & larynx)

- hyperemic tonsils

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2
Q

Primary cause of Pharyngitis/tonsillitis

A

Viral- most common
- Group A Streph (kiddos 5-15) Primary 75% likely strep

  • Staph Pyogenes=5-15%
  • other viruses rhino, corona, flu, aden, HSV, coxsackie, EBV, CMV
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3
Q

Clinical Presentations of Pharyngitis/tonsillitis if caused by Rhino/Coronavirus ?

A

= coryzal symptoms

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4
Q

Clinical Presentations of Pharyngitis/tonsillitis if by EBV/CMV ?

A 
fatigue
fever
"shaggy" exudate
general adenopathy
splenomegaly
1/3 may have secondary strep
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5
Q

Clinical Presentations of Pharyngitis/tonsillitis if caused by Flu?

A
  • fatigue
  • myalgias
  • headache
  • cough
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6
Q

Clinical Presentations of Pharyngitis/tonsillitis if caused by adenovirus?

A

conjunctivitis

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7
Q

Clinical Presentations of Pharyngitis/tonsillitis if caused by HSV?

A

exudate
vesicles
ulcers on palate

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8
Q

Clinical Presentations of Pharyngitis/tonsillitis if caused by coxsackie?

A

vesicles on soft palate/uvula

rupture to white ulcers

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9
Q

Clinical Presentations of Pharyngitis/tonsillitis if caused by strep?

A 
Centor Criteria=
fever
tonsillar exudate
tender cervical lymphadenopathy
no URI/cough symptoms

scarlatiniform rash

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10
Q

Work up/ labs for Pharyngitis/tonsillitis ?

A
  • Centor Criteria
  • Throat Swab - rapid strep/ Culture
  • Labs; CBC (usually not helpful), mono spot (helpful, but can have false negatives)
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11
Q

Tx of Pharyngitis/tonsillitis ?

A

Viral–> so supportive care (pain meds/gargling)

Strep–> Penicillin= first line tx
other abx=amoxil (pedes)
cephalosporin
Macrolide

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12
Q

What bacterial profile found in Peritonsillar Abscess?

A

Same as tonsillitis, with the addition of Fusobacterium

***Staph pyogenese most common

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13
Q

isolated tonsillar enlargement resulting from a bacterial infection that has penetrated the tonsillar capsule and perhaps the surrounding tissues describes what?

A

Peritonsillar Abscess

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14
Q

HX/ Exam of Peritonsillar Abscess?

A

increased pain,
trismus (inability to open mouth)
deviation of soft palate/uvula
hot potato voice

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15
Q

Work up for Peritonsillar Abscess?

A

manual exam
labs
ultrasound
CT

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16
Q

Tx of Peritonsillar Abscess

A 
aspiration 
I&D (be careful of vessels/nerves in back of mouth)
IV abx
pain meds
steroids (to decrease swelling)
17
Q

Where is a retropharygeal abscess located?

A
  • retropharyngeal space between pharynx/cervical vertebrae

- extends from base of the skull to mediastinum

18
Q

How do retropharyngeal abscesses present?

A
  • stiff neck
19
Q

What microbes are responsible for retropharygeal abscess ?

A

strep, staph, H. Flu, Klebsiella

20
Q

Work up/ labs retropharygeal abscess?

A

soft tissue neck x-ray (>1/2 width of adjacent vertebral body)
consider labs
consider CT

21
Q

Tx of retropharyngeal Abscess?

A

IV abx (cephalosporin + amp-sulbactam or clinda)
ENT consult
Aspiration
I&D

22
Q

What are the etiologies of Ludwigs Angina?

A

More common…

  1. Poor dentition
  2. Deep tissue infection of the submandibular space
23
Q

What bacteria common in Ludwigs Angina?

A

-Staph
-Strep
Bacteroides
Fusobacterium

24
Q

Hx/Exam of Ludwigs Angina?

A

submental/sublingual swelling, drooling fever

25
Q

Workup/labs for Ludwigs Angina?

A

CT
ultrasound (both assess for cellulitis vs abscess)
soft tissue xray= may show STS or gas

26
Q

tx of Ludwigs Angina?

A

IV abx
surgical I&D
dental F/U after resolved

27
Q

Complications of Ludwigs Angina?

A
  • airway compromise
  • thrombophlebitis of IJV (Lemierre Syndrome)
  • associated w headache
  • septic pulmonary emboli

Clin Med I - ENT (13 decks)

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