Throat

Question 1

Centor Criteria

Answer 1

1. Absence of cough 1pt
2. Anterior CLAD 1 pt
3. Fever: >38 C (100 F) 1 pt
4. Tonsillar Exudate 1 pt
5. 3-14 yo: 1 pt
   15-44 yo: 0 pt
   >45 yo:-1 pt

Question 2

RED FLAG:

Sudden severe sore throat in older patients

Answer 2

Aortic Dissection

Pneumothorax

Question 3

These systemic diseases may present as sore throat

Answer 3

Juvenile Rheumatoid Arthritis
Toxic Shock (Desquamating hands and high fever)
Hepatitis
Polio
Leukemia
Mycoplasma pneumonia
HIV

Question 4

Common cause of Community acquired pneumonia and who gets it most

Answer 4

M. pneumoniae

school aged kids and college students

Question 5

Sx of M pneumoniae respiratory infxn and how many folks develop community acquired pneumonia from it?

Answer 5

Pharyngitis, cough, rhinorrhea, ear pain

10% develop pneumonia

Question 6

Wide net DDX: Other Head and Neck D/O that mimic pharyngitis

Answer 6

Otitis Media
Thyroiditis
Post Nasal Drip (warm drinks)
mumps parotiditis
SCM and cervical spine lesions
Glossopharyngeal nerualgia (CN IX) 
                  -sensory to throat BIG PAIN!!!!
Epiglottis: RED FLAG!!! Drooling, can't swallow, distress
Oropharyngeal CA

Question 7

Bacterial Infxn: Papillary gingiva are gray; foul breath; CLAD
Risk Factors: smoking; poor hygiene; teenagers

Answer 7

Necrotizing Gingivits
Vincents Angina
Trench Mounth

Question 8

Group of Inflamed vesicles leading to superficial ulcerations on oral mucosa and lips

Answer 8

Herpes Simplex

Question 9

Painful Lesions on tongue, mouth, possible hands and feet. Self limiting. ***Very contagious

What is it and What pathogen causes it?

Answer 9

Hand Foot and Mouth

Coxsackie Virus

Question 10

PARQ for oral inhaled corticosteroids

Answer 10

Rinse mouth immediately after each use to prevent candida

Question 11

Posterior CLAD, TTP. Mb adenopathy in axilla and groin
myaglia, petechiae on back of pharnyx, tonsil exudate
MB hepato(12%)/spleno(52%)megaly

Answer 11

mono Epstein Barr Viral etiology

Question 12

When monospot is most sensitive

Answer 12

2 weeks after contracting

Question 13

If monospot is neg and there are other clinical signs/sx consider this ddx. Do test if after two weeks, it still isn’t mono.

Answer 13

CMV

Question 14

Mono Labs

Answer 14

Mildly elevated transanimase levels (ALT, AST, GGT)

Atypical lymphocytes

Question 15

Mono complications: PARQ

Answer 15

Severe airway obstruction (kissing tonsils) 1-5% pts
Fatigue: Up to 6 months post infxn 9-22% pt
Hemolytic anemia 1-3%
Thrombocytapenia <1%

**Splenic Rupture: <1% pt. Lymphocytic infiltration
From minor trauma i.e turning in bed, coughing
Safe to return to activities after 1 month

Question 16

Malignancy associated with EBV

Answer 16

Burkitts Lymphoma; nasopharyngeal carcinoma; B cell lymphoma