(PM3A) ENT - Throat Flashcards
What composes the throat?
(1) Pharynx
(2) Larynx
What are the subdivisions of the pharynx?
(1) Nasopharynx
(2) Oropharynx
(3) Laryngopharynx
Where is the epiglottis?
By the larynx
What is the role of the epiglottis?
Prevents food from entering the trachea
What is the hard palate?
Roof of the mouth
What is the larynx?
Vocal chords
Where is the adenoid?
In the nasopharynx
Where are the tonsils?
In the oropharynx
What is the trachea?
Windpipe
What is the oesophagus?
Digestive pipe
Connects pharynx to stomach
What is the main condition of the throat?
Sore throat
(1) Pharyngitis
(2) Tonsillitis
Which conditions can cause a sore throat?
(1) Pharyngitis
(2) Tonsillitis
What is an acute sore throat?
Pharyngitis/ tonsillitis
Inflammation of the throat
What is laryngitis?
Inflammation of the larynx
Common symptom affects the voice
What often causes an acute sore throat?
Viral infection
What often causes an acute sore throat?
Viral infections
Can be bacterial
via airborne drops or direct contact
What often causes pharyngitis?
Viral infections
Can be bacterial
via airborne drops or direct contact
What often causes tonsillitis?
Viral infections
Can be bacterial
via airborne drops or direct contact
What are some common symptoms of pharyngitis?
(1) Sore throat
(2) Fever
(3) Difficulty swallowing
(4) Throat inflammation
What are some common symptoms of tonsillitis?
(1) Sore throat
(2) Fever
(3) Difficulty swallowing
(4) Tonsil inflammation - mainly
Are acute sore throat conditions self-limiting?
Yes
How is the treatment plan for acute sore throat determined?
(1) FeverPAIN score
(2) CENTOR score
What is the treatment for bacterial acute sore throat?
(1) Phenoxymethylpenicillin 500mg QDS 5-10 days
(2) Painkillers
(3) Fluids
What is the FeverPAIN score?
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
What is coryza?
Catarrhal inflammation of the mucosal membrane
What is the CENTOR score?
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
What FeverPAIN score indicates a patient may benefit from antibiotics?
4-5
What CENTOR score indicates a patient may benefit from antibiotics?
3-4
When is a patient with acute sore throat given antibiotics immediately?
Systemically unwell
Referral to hospital for severe cases
When are antibiotics used for acute sore throats?
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
What happens if a patient with acute sore throat is given a FeverPAIN score of 2 or 3?
(1) Consider no ABx
(2) Back-up ABx prescription
Other than potentially antibiotics, fluids, and pain management, what can a patient with an acute sore throat potentially benefit from?
Medicated lozenges in adults
What causes oral ulceration?
Ulceration of the oral mucosa
(1) Trauma
(2) Infectoin
(3) Carcinoma
(4) Nutritional deficiencies
(5) Gastro-intestinal disease
(6) Haemopoietic disorders
(7) Drug therapy
What are some treatment options for oral ulceration?
(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
What is thrush?
Fungal infection of the mouth
Usually caused by Candida
What commonly causes thrush?
(1) Inhaled corticosteroids
(2) Broad-spectrum ABx
(3) Compromised immune system
What is the treatment for thrush?
(1) Nystatin oral suspension
(2) Miconazole gel
(3) Fluconazole capsules/ IV if not recovering
What is the treatment for severe invasive candidiasis?
Amphotericin
What are viral infections of the throat commonly caused by?
(1) Herpes simplex
How is a herpes simplex throat infection treated?
Local - Aciclovir
Systemic - valaciclovir
What is xerostomia?
Dry mouth
What is another name for dry mouth?
Xerostomia
What causes dry mouth?
Antimuscarinic/ diuretic drugs
What causes xerostomia?
Antimuscarinic/ diuretic drugs
How is dry mouth treated?
Artificial saliva
How is xerostomia treated?
Artificial saliva
