The Throat Flashcards
Most common causes of pharyngitis?
Adenovirus, rhinovirus.
Most common causes of tonsillitis?
Usually viral
Group A strep or H influenza
WHatr are the censor criteria?
No Cough
Tonsillar exudate
Tender cervical lymphadenopathy
Temp > 38 degrees.
Management of tonsillitis?
If cantor criteria 3 or more, then u can use ABx.
1) Penicillin V (10 days)
2) Clarithromycin (5 days)
Treatment of tonsillitis if unable to swallow?
Benzylpenicillin IV 10 days
Clarithromycin IV 5 days.
Criteria for tonsillectomy?
> 7 in one year
> 5 episodes per year for 2 years.
> 3 episodes per year for 3 years.
Name 2 complications of tonsillitis ?
Scarlet fever and quinsy.
What is scarlet fever?
Usually present within 3 weeks of tonsillitis with a stawrberry tongue and red roughened rash in armpits, chest and groin that is worse in the kin folds.
Clinical syndrome of quinsy?
Odynophagia,
Hot potatoe voice
Trismus.
O/E unilaterally large tonsil with deviation of the uvula.
What causes glandular fever/infectious mononucleosis?
Epstein Barr virus.
How does glandular fever present?
Sore throat plus:
- transient macular rash.
Petechia rash on palate
Lymphadenopathy for > 4wweks
Assocs with glandular fever:
Hepatitis, Splenomegaly, anaemia.
What would you see on examination of someone with glandular fever?
Bilateral tonsillar enlargement w/ membranous exudate +- hepatosplenomegaly.
Management of glandular fever?
Supportive care
Antibiotics not indicated.
Use of amoxicillin containing antibiotics will result in a widespread generalised macula-popular rash.
What should you advise patients with glandular fever?
Avoid return to sport for 6 weeks due to risk of splenic rupture.
Who is at risk of oral thrush?
HIV, diabetes, inhaled steroids, chemotherapy.
Presentation of oral thrush?
Sore throat with white patches that can be scraped off.
Management of oral thrush?
Nystatin liquid or miconazole gel or oral fluconazole.
What is the cause of dipheriae?
Corynebacterium Diprheira
How does diphtheria present?
Grey/white psedomembranous coat ove the throat.
Diagnosed by throat swab?
Management and complications of diphtheria?
Anti-toxins +/- antibiotics.
Can be complicated by shock, neuropathy,. Or cardiac compromised due to toxin release.
How would someone with big adenoids presnet?
Hyponasal voice
Obligate mouth breathing
Snoring and obstructive sleep apnoea.
Management = surgical excision.
What is a pharyngeal pouch?
It is a diverticulitis of the oesophagus through the inferior constrictor muscles?
How is a pharyngeal pouch diagnosed?
Barium swallow. Can surgically correct.
What is laryngomalacia?
Main congenital abnormality of the larynx in which the cartilages are soft and immature which leads to collapse.
Presentation of laryngomalacia?
Strider while sleeping, excited or specific situations.
Managament of laryngomalacia?
Most cases resolve themself by 2 years.
Some severe cases require corrective surgery.
Management of emergency laryngomalacia/.
Call ENT and arrange a tracheostomy kit.
