Sore Throat Flashcards
Is a sore throat synonymous with pharyngitis?
• Sore throat is not always synonymous with pharyngitis
What is usually the problem if examination reveals erythema of the posterior pharynx?
infectious pharyngitis is usually the problem
What are some common causes of infectious pharyngitis?
1) Group A beta-hemolytic streptococci
2) Non-group A beta-hemolytic streptococci
3) Groups B, C, F, and G streptococci have been implicated
4) Chlamydia trachomatis
5) Mycoplasma pneumoniae
6) Epstein-Barr virus
7) Influenza and parainfluenza
8) Adenovirus
When the patient’s description of sore throat is atypical of infectious pharyngitis, and especially when examination of the pharynx is also completely normal what other causes could it be?
1) Head and neck disorders
2) Systemic disease
3) Mediastinal disorders
What are different head and neck disorders that could cause atypical sore throats? (8)
1) Otitis
2) Sinusitis
3) Salivary gland infection
4) Thyroiditis
5) Neck muscle strain
6) Epiglottitis
7) Allergy
8) Foreign body
What are different systemic diseases that could cause atypical sore throats? (8)
1) Viral hepatitis
2) JRA
3) Rubella
4) Poliomyelitis
5) Acute leukemia
6) Toxic shock syndrome
7) Temporal arteritis
8) AIDS
What are different mediastinal disorders that could cause atypical sore throats? (5)
1) Myocardial infarction
2) Aortic dissection
3) Angina pectoris
4) Esophagitis
5) Esophageal spasm
Is infectious mononucleosis a common cause of sore throats in adolescents?
No, it is an uncommon cause of sore throat in adolescents
What are some infectious mononucleosis of common clinical findings? (5)
1) Pharyngitis
2) Fever
3) Cervical adenopathy (most sensitive)
4) Splenomegaly
5) Palatal petechiae
What tests are performed for infectious mononucleosis? (3)
- WBC count and differential
- Monospot test (quick test for Heterophile antibody)
- EBV antibody titers
Should all patients have routine testing for mononucleosis?
• Routine testing for mononucleosis in all patients with sore throat is wasteful
What is the rationale for early diagnosis and antibiotic intervention of streptococcal pharyngitis?
• Prevention of post-streptococcal glomerulonephritis (PSGN) and acute rheumatic fever (ARF)
What is included in the Reilly Protocol?
• Physical findings as a predictive clue of strep specifically:
- Tonsillar exudate
- Cervical adenopathy
- Fever
What are the odds presented by the reilly protocol for the physical findings?
- Tonsillar exudate
- Cervical adenopathy
- Fever
• 2:3 odds of strep with all three
• 1:6 odds of strep with any findings
• 1:30 odds of strep with no findings
According to the Reilly protocol, what are the culture and treatment decisions to diagnose strep throat?
using classic throat culture and RADT (rapid antigen detection test)
According to the Reilly protocol, what classifies a low risk patients?
• No exudate or nodes or fever
According to the Reilly protocol, is testing done on a low risk patients?
Yes, RADT on all patients but No cultures necessary. Treat positive patients
According to the Reilly protocol, if testing is negative on a low risk patients what occurs?
• If negative, no treatment or cultures necessary