Throat Flashcards
Little red and white spots on palate. Poor hygiene, smokers, protein deficiency, poorly fitted dentures, radiation therapy, allergies, iron efficiency, vitamin B deficiency.
Redness, swelling, occasional bleeding, halitosis; use Hx to diagnose
Stomatitis
Drug/referral and consider indications, contraindications, cost effectiveness; remove source or treat w/ medication in systemic or use topical anesthetic for pain (2% lidocaine)
Treatment stomatitis
Present as single or multiple painful, round ulcers with yellow-gray centers and red halos. They occur on nonkeratinized mucosa (buccal or labial) and are recurrent
Aphthous ulcer; ulcerative stomatitis
Non-specific; topical therapies like corticosteroids.
1-week prednisone taper, cimetidine can be used as maintenance therapy
Aphthous ulcer treatment
Infection more likely in patients who wear dentures or those w/ diabetes/immunocompromised states, chemo/radiation, corticosteroid or broad abx treatment.
Throat or mouth pain w/ creamy white patches that can be scraped off to reveal red erythematous mucosa
Wet prep or biopsy can be done
Oral candidiasis
Antifungals (ketoconazole or fluconazole, clotrimazole troches, nystatin liquid rinse)
Oral candidiasis treatment
Elders w/ poor fitting dentures, children
Bx infection (impetigo; honey-colored crusts and ulceration) or yeast; Yellow crusting sores on sides of mouth
Dx visual but can culture
Angular chelitis
Bacterial impetigo: Bactroban or topical ABX
Yeast: Clotrimazole (topical)
Barrier cream to stop irritation before it becomes infection
Angular chelitis treatment
Infection of mouth and lips by HSV1; herpes labials usually involves trigger
Prodromal period (tingling), pain, burning, or itching can occur at the site before the sore appears. The cluster or sores erupt into blisters, then quickly turn into shallow grey ulcers with a red base, become crusted or scabbed; May have palpable lymph nodes
Swab sore and send to lab, Tzanck smear test; antigen antibody studies (PCR) usually just Dx clinically
Herpes simplex/cold sores/ herpes gingivostomatitis
Tylenol or ibuprofen for pain; acyclovir, valtrex, famvir, and topical penciclovir. Mouth wash with lidocaine and benadryl.
Cold sore treatment
Sore throat. More commonly viral than bacterial Differentiate between GABHS to prevent complications as well as to limit unnecessary antibiotic use
Acute pharyngitis
Fever, tender anterior cervical nodes, lack of cough, pharygotonsillar exudate
Rapid strep test, if negative and still suspicious culture
GABHS if all four, only three likely, only one most likely not GABHS
Coryza, hoarsness, cough
Viral pharyngitis
IM Penicillin if patient non compliant
Oral penicillin or cefuroxime can be used. E-mycin or another macrolide can be substituted in cases of PCN allergy.
Complications = scarlet fever, glomerulonephritis, abscess formation
GABHS bacterial pharyngitis
Viral and follows URI. Bacteria can include M. Cattarhalis and H. Influenzae. Hoarseness hallmark symptom, cough can be present, pain is atypical.
Rx: Vocal rest; if bacterial E-mycin, cefuroxime, amox-Clav can decrease hoarsness/cough. Oral or IM corticosteroids can be used for performers but vocal fold evaluation first
Laryngitis
