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13 ENT > Sore Throat > Flashcards

Sore Throat Flashcards

1
Q

pain, irritation, or scratchiness of the throat that often worsens when swallowing

A

sore throat (symptom of pharyngitis)

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2
Q

most common cause of sore throat

sore throat usually occurs with ___

A

infectious (viral)

common cold

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3
Q

non-infectious causes of sore throat

A

concomitant illness or physiochemical factors

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4
Q

pharyngitis vs tonsillitis

A

pharyngitis: diffuse inflammation of oropharynx
tonsillitis: inflammation of tonsils only

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5
Q

pharyngeal structures

A 
tonsils
nasopharynx
epiglottis
base of tongue
uvula/soft palate
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6
Q

most common causative agents of sore throat

A

rhinovirus and adenovirus

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7
Q

pathophysiology of viral pharyngitis

A

exposure -> virus implants on resp/gi tract -> intracellular access -> replicate -> shedding and infection of other cells -> spread to more distant target organs through mucus later, lymphatics, blood

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8
Q

throat pain and irritation are most probably caused by inflammatory mediators like ___

A

prostaglandins and bradykinins

released as a response to the resulting cellular damage or death OR from host immune response

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9
Q

symptoms pointing to viral etiology

A

coryza, cough, hoarseness, conjunctivitis, diarrhea, malaise/arthralgia

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10
Q

PE of viral pharyngitis

A
  • erythema of oropharynx
  • discrete ulcerative stomatitis
  • no exudates
  • viral exanthems
  • usually no anterior adenopathies
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11
Q

treatment of viral pharyngitis

A
  • self-limiting (gone in 5-7 d)

- supportive and symptomatic

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12
Q

most useful symptomatic treatment in viral pharyngitis

A

nsaids and antipyretics

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13
Q

t/f corticosteroids are required treatment in vp

A

false, role still undefined

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14
Q

t/f vitamin c can reduce duration of symptoms in vp

A

true

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15
Q

t/f high doses of vitamin c can affect severity and duration of vp

A

false

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16
Q

t/f routine supplementation of vit c is justified

A

false

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17
Q

effects of zinc at onset of colds

A

decreases duration but not severity (75 mg within 24 hrs of symptom onset)

18
Q

t/f zinc can be used as a prophylactic treatment in vp

A

false

19
Q

oral gargles, lozenges, and sprays can give ___

A

symptom relief

20
Q

t/f oral gargles, lozenges, and sprays can resolve infections faster

A

false, no solid evidence

21
Q

t/f ice cream, sweets, chocolate, etc are risk factors for sore throat

A

false

22
Q

t/f sore throat is a common symptoms of covid 19

A

true

23
Q

most common presenting symptoms of covid

A

fever, cough, fatigue, dyspnea, headache, sore throat

24
Q

management for covid19

A
  • no treatment
  • remdesivir improves recovery time and reduces mortality
  • dexamethasone reduces mortality
  • best strategy is prevention
25
Q

bacterial pharyngitis is most common in age ___

A

5-15 years

26
Q

most common pathogenic organism in bacterial pharyngitis

A

group 1 beta hemolytic strep pyogenes (gabhs or gas)

27
Q

other organisms in bp

A 
non group a strep
arcanobacterium haemolyticum
stis (gonorrhea, syphilis, chlamydia)
tb
tularemia
diptheria
28
Q

t/f gabh is pathogenic only in humans

A

true, <5% of adults are asymptomatic carriers

29
Q

transmission of bp

A
  • most common: aerosolized microdroplets
  • less common: direct contact
  • rare: ingestion of contaminated food
30
Q

symptomatology of bp

A

odynophagia (panful swallowing)
fever, headache, nausea, vomiting, abdominal pain

unusual: cough, hoarseness, coryza, diarrhea

31
Q

pe for bp

A 
tonsillopharyngeal inflammation
patchy tp exudates
palatal petechiae
beefy red swollen uvula
anterior cervical adenitis
32
Q

challenges in differentiating gabh from viral

A
  • broad overlap in clinical presentations

- low accuracy of clinical diagnosis

33
Q

objectives of diagnosing bacterial pharyngitis

A
  • main: prevent acute rheumatic fever and sequelae (rhd)
  • prevent suppurative complications
  • improve clinical s/sx
  • reduce transmission
  • prevent inappropriate antimicrobial therapy
34
Q

lab diagnosis for bp

A
  • gold standard: culture of throat swab in sheep agar
  • rapid antigen detection test (low false positives)
  • aso titers (not helpful, 3-8 wks after infection)
35
Q

mcisaac scoring systemp

A 
fever
tonsillar exudate
absent cough
anterior cervical lad
3-14 yrs
15-44 yrs 0
>44 yrs -1
36
Q

acp algorithm

A

0-1 no treatment
2-3 rapid antigen test
4-5 antibiotic

37
Q

nice guidelines

A

0-2 no treatment

3-5 antibiotic

38
Q

complications of streptococcal pharyngitis

A

acute rheumatiic fever

  • rhd (1-5% of rf)
  • antibiotic treatment within 9 days of onset prevents arf
poststreptococcal gn (rare)
- incidence is not affected by treatment
39
Q

doc for strep pharyngitis

A

penicillin or amoxicillin for 10 days

40
Q

other treatments for strep pharyngitis

A
  • cephalosporin, clindamycin, clarithromycin, azithromycin
  • nsaids
  • corticosteroids (undefined)
41
Q

tonsillectomy is done for patients that __

A

satisfy the paradise criteria

42
Q

paradise criteria for tonsillectomy

A
  • minimum frequency of sore throat episodes
  • clinical features PLUS presence of more/= 1 quality
  • treatment
  • documentation

13 ENT (18 decks)

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