(PM3A) ENT - Throat

Question 1

What composes the throat?

Answer 1

(1) Pharynx

(2) Larynx

Question 2

What are the subdivisions of the pharynx?

Answer 2

(1) Nasopharynx
(2) Oropharynx
(3) Laryngopharynx

Question 3

Where is the epiglottis?

Answer 3

By the larynx

Question 4

What is the role of the epiglottis?

Answer 4

Prevents food from entering the trachea

Question 5

What is the hard palate?

Answer 5

Roof of the mouth

Question 6

What is the larynx?

Answer 6

Vocal chords

Question 7

Where is the adenoid?

Answer 7

In the nasopharynx

Question 8

Where are the tonsils?

Answer 8

In the oropharynx

Question 9

What is the trachea?

Answer 9

Windpipe

Question 10

What is the oesophagus?

Answer 10

Digestive pipe

Connects pharynx to stomach

Question 11

What is the main condition of the throat?

Answer 11

Sore throat

(1) Pharyngitis
(2) Tonsillitis

Question 12

Which conditions can cause a sore throat?

Answer 12

(1) Pharyngitis

(2) Tonsillitis

Question 13

What is an acute sore throat?

Answer 13

Pharyngitis/ tonsillitis

Inflammation of the throat

Question 14

What is laryngitis?

Answer 14

Inflammation of the larynx

Common symptom affects the voice

Question 15

What often causes an acute sore throat?

Answer 15

Viral infection

Question 16

What often causes an acute sore throat?

Answer 16

Viral infections

Can be bacterial

via airborne drops or direct contact

Question 17

What often causes pharyngitis?

Answer 17

Viral infections

Can be bacterial

via airborne drops or direct contact

Question 18

What often causes tonsillitis?

Answer 18

Viral infections

Can be bacterial

via airborne drops or direct contact

Question 19

What are some common symptoms of pharyngitis?

Answer 19

(1) Sore throat
(2) Fever
(3) Difficulty swallowing
(4) Throat inflammation

Question 20

What are some common symptoms of tonsillitis?

Answer 20

(1) Sore throat
(2) Fever
(3) Difficulty swallowing
(4) Tonsil inflammation - mainly

Question 21

Are acute sore throat conditions self-limiting?

Answer 21

Yes

Question 22

How is the treatment plan for acute sore throat determined?

Answer 22

(1) FeverPAIN score

(2) CENTOR score

Question 23

What is the treatment for bacterial acute sore throat?

Answer 23

(1) Phenoxymethylpenicillin 500mg QDS 5-10 days
(2) Painkillers
(3) Fluids

Question 24

What is the FeverPAIN score?

Answer 24

1 point for each, max score of 5

(1) Fever
(2) Purulence
(3) Severely inflamed tonsils
(4) No cough/ coryza
(5) Attend within ≤3 days

Question 25

What is coryza?

Answer 25

Catarrhal inflammation of the mucosal membrane

Question 26

What is the CENTOR score?

Answer 26

1 point for each, max score of 4 (1) Tonsiliar exudate (2) Tender anterior cervical lymphadenopathy/ lymphadenitis (3) History of fever - >38ºC (4) No cough

Question 27

What FeverPAIN score indicates a patient may benefit from antibiotics?

Answer 27

4-5

Question 28

What CENTOR score indicates a patient may benefit from antibiotics?

Answer 28

3-4

Question 29

When is a patient with acute sore throat given antibiotics immediately?

Answer 29

Systemically unwell Referral to hospital for severe cases

Question 30

When are antibiotics used for acute sore throats?

Answer 30

Typically self-limiting (1) If symptoms worsen after 7 days (2) Back-up prescriptions if no improvement in 3-5 days (3) If patient becomes very unwell

Question 31

What happens if a patient with acute sore throat is given a FeverPAIN score of 2 or 3?

Answer 31

(1) Consider no ABx | (2) Back-up ABx prescription

Question 32

Other than potentially antibiotics, fluids, and pain management, what can a patient with an acute sore throat potentially benefit from?

Answer 32

Medicated lozenges in adults

Question 33

What causes oral ulceration?

Answer 33

Ulceration of the oral mucosa (1) Trauma (2) Infectoin (3) Carcinoma (4) Nutritional deficiencies (5) Gastro-intestinal disease (6) Haemopoietic disorders (7) Drug therapy

Question 34

What are some treatment options for oral ulceration?

Answer 34

(1) Benzydamine - NSAID oromucosal spray (2) Choline salicylate gel - e.g. Bonjela, not for <16yrs old (3) Topical anaesthetics -e.g. lidocaine (4) Topical hydrocortisone + betamethasone - inflammation

Question 35

What is thrush?

Answer 35

Fungal infection of the mouth Usually caused by Candida

Question 36

What commonly causes thrush?

Answer 36

(1) Inhaled corticosteroids (2) Broad-spectrum ABx (3) Compromised immune system

Question 37

What is the treatment for thrush?

Answer 37

(1) Nystatin oral suspension (2) Miconazole gel (3) Fluconazole capsules/ IV if not recovering

Question 38

What is the treatment for severe invasive candidiasis?

Answer 38

Amphotericin

Question 39

What are viral infections of the throat commonly caused by?

Answer 39

(1) Herpes simplex

Question 40

How is a herpes simplex throat infection treated?

Answer 40

Local - Aciclovir Systemic - valaciclovir

Question 41

What is xerostomia?

Answer 41

Dry mouth

Question 42

What is another name for dry mouth?

Answer 42

Xerostomia

Question 43

What causes dry mouth?

Answer 43

Antimuscarinic/ diuretic drugs

Question 44

What causes xerostomia?

Answer 44

Antimuscarinic/ diuretic drugs

Question 45

How is dry mouth treated?

Answer 45

Artificial saliva

Question 46

How is xerostomia treated?

Answer 46

Artificial saliva