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Nose/Throat - Clinical Medicine IV > Pharyngitis > Flashcards

Pharyngitis Flashcards

1
Q

What is the nickname for pharyngitis?

A

sore throat

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2
Q

What is pharyngitis?

A

inflammation of the pharynx

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3
Q

What is the most common cause of pharyngitis?

A

viral

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4
Q

What type of pharyngitis infection is more serious and why?

A

group A beta hemolytic strep (GAS) due to risk of rheumatic fever and glomerulonephritis

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5
Q

What do you do for GAS?

A

give ABX

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6
Q

What are the signs and symptoms of pharyngitis?

A

throat pain, enlarged tonsils, pharyngeal erythema, soft palate petechia, anterior cervical adenopathy, painful swallowing, high fever, odynophagia, chills, malaise, headache, anorexia, abdominal pain

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7
Q

What are the most common viral cause of pharyngitis?

A

rhinovirus, adenovirus, parainfluenza virus, coxsacheivirus, HSV, EBV, CMV, RSV

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8
Q

What bacteria causes pharyngitis?

A

strep pyogenes, n. gonorrhea, corynebacterium diptheriae, h. flu, m. cat

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9
Q

What is the fungal cause of pharyngitis?

A

candida in immunocompromised

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10
Q

What are some less common cause of pharyngitis?

A

chemical, GERD, postnasal drip, neoplasms, m. pneumoniae, chlamydia pneumoniae

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11
Q

What are serious causes of pharynigitis?

A

GAS, corynebacterium diptheria - myocarditis and peripheral neuritis

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12
Q

What are some predisposing factors to pharyngitis?

A

epidemics, recent family hx, close quarters, immunosuppression, oral sex, recent illness

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13
Q

What is the age range for streptococcal infections?

A

5-18 yo mainly

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14
Q

What do you think if there is pharyngitis in

A

viral and other people in the household have this?

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15
Q

What is the dx for pharyngitis?

A

rapid strep antigen test (RADT)
Throat culture
CBC with diff
EBV serology

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16
Q

What is RADT?

A

strep test - latex agglutination or enzyme linked immunoassay, fast results, ELISA better than latex

17
Q

What is a disadvantage of RADT?

A

high false negatives, follow up with throat culture

18
Q

How do you treat high risk pt with pharyngitis?

A

start ab immediately, throat culture neg then stop ABX

19
Q

What are complications of pharyngitis?

A

rheumatic fever, acute glomerulonephritis, supprative conditions

20
Q

What are some supprative conditions?

A

peritonsillar abscess, otitis media, mastoiditis, sinusitis, bacteremia, pneumonia

21
Q

What do you suspect if pt has sore throat and appears ill and drooling?

A

epiglottitis

22
Q

What do you suspect if patient has dysphagia and develops rash on amoxicillin?

A

mononucleosis - stop ABX

23
Q

What is the criteria for non-high risk strep pharyngitis?

A

Absence of cough, rhinorrhea, and conjunctivitis
Fever at least 38.3 degrees C (100.9 degrees F) within last 24 hours
Erythema, swelling, or exudates of tonsils or pharynx
Tender anterior cervical nodes = 1cm
Age 5 to 15 years
Season is November to May

24
Q

What do you do for pt with 0-1 points?

A

no abx or throat culture necessary

25
Q

What do you do for pt with 2-3 points?

A

throat culture and treat with ABX if culture positive

26
Q

What do you do for pt with 4-5 pt?

A

treat w/ ABX empirically

27
Q

When do most pharyngitis resolve?

A

3-4 self limited

28
Q

What is the key for tx of pharyngitis?

A

shorten duration if within 48 h and prevent rheumatic fever (within 9 days)

29
Q

What do you treat pharyngitis with?

A 
Penicillin VK, 500 mg PO bid for 10 d
or
Cephalexin, 250 mg PO qid for 10 d
or
Erythromycin, 250 mg PO qid for 10 d
or
Benzathine penicillin G, single dose of 1.2 million units IM
or
Clindamycin, 300 mg PO tid for 10 d
30
Q

What is the drug of choice for pharyngitis?

A

penicillin VK or amoxicillin

31
Q

What do you use if pencillin allergy in pharyngitis?

A

clindamycin or cephalexin

32
Q

What is the dosing for amoxicillin kids?

A

once a day for 10 days

33
Q

What do you give if pt has recent abx with pharyngitis?

A

macro, clinda, augmentin

34
Q

What is indicated for pt at risk of recurrent rheumatic fever?

A

penicillin G IM q3-4 wks

35
Q

How do you treat GAS carriers?

A

clindamycin if have recurrent episodes

36
Q

What causes viral pharyngitis?

A

HSV or influenza virus

37
Q

How do you treat viral pharyngitis?

A

oseltamivir and zanamivir start tx 36-48 hrs of onset

38
Q

What is symptomatic tx?

A

acetaminophen, ibuprofen, saltwater gargling, soft and cool food

Nose/Throat - Clinical Medicine IV (12 decks)

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