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J ENT > Throat conditions > Flashcards

Throat conditions Flashcards

1
Q

most common microbio of bacterial throat infection

A

strep pyogenes

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2
Q

what is acute pharyngitis

A

inflammation of the oropharynx

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3
Q

what is acute tonsillitis

A

inflammation of the palatine tonsils

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4
Q

which age groups are throat infections common in

A

5-10

15-25

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5
Q

where may pain refer to in a throat infection

A

ear (otalgia)

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6
Q

presentation of throat infection (4)

A

pain at back of mouth
pain when swallowing (odynophagia)
fever
lymphadenopathy

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7
Q

whats the tonsillitis criteria name for whether they should get antibiotics or not

A

centor criteria

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8
Q

initial investigations for throat infection

safety netting

A

nothing

come back in 1 week if not resolved

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9
Q

treatment of throat infection centor criteria 1 or 2

A

self limiting 3-7 days - rest, avoid hot drinks, ibuprofen for pain and fever

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10
Q

what are the centor criteria for throat infections

A

fever
lymphadenopathy
no cough
pus (tonsillar exudate)

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11
Q

treatment of throat infection centor criteria 3 or 4

why dont you just do this for everyone with a throat infection

A

antibiotics - penicillin V 500mg QDS 10 days

2/3 of throat infections are viral

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12
Q

are most throat infections viral or bacterial

A

2/3 are viral

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13
Q

microbio of viral throat infection (6)

A 
rhinovirus 
parainfluenzae
HSV
adenovirus
EBV (glandular fever) 
gonorrhoea
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14
Q

what investigation would you do if someone came back after 1 week and their throat infection hadn’t cleared up

A

antistreptococcal antibody tests for strep cause

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15
Q

if after 1 week throat infection hadn’t cleared up In a 15-25 year old, what should you suspect

A

infectious mononucleosis

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16
Q

recurrent tonsillitis treatment

A

tonsillectomy

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17
Q

ear complication of throat infection

A

otitis media

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18
Q

unilateral sore throat
dysphagia/odynophagia
peritonsillar bulge

recent throat infection

A

quinsy

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19
Q

quinsy treatment (2)

A

antibiotics and aspiration

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20
Q

more serious version of quinsy

A

parapharygeal abscess

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21
Q

complication of strep throat infection

3 weeks after sore throat; fever, arthritis, pancarditis

A

rheumatic fever

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22
Q

complication of strep throat infection

1-3 weeks after sore throat; haematuria, albuminuria, oedema

A

glomerulonephritis (acute rapidly progressive glomerulonephritis)

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23
Q 
URTI 
v sore throat 
fever 
grey/white membrane across pharynx 
swelling = obstruction
A

diphtheria

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24
Q

significance of diphtheria bacteria exotoxin

A

toxic to heart and brain

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25
Q

treatment of diphtheria

A

antitoxin

antibiotics - penicillin

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26
Q

is diphtheria common

A

no bc of vaccination

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27
Q

how does candida/oral thrush look

A

white patches on raw red mucosa

in throat/mouth (not just throat like diphtheria)

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28
Q

another name for infectious mononucleosis

A

glandular fever

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29
Q

virus causing infectious mononucleosis

A

EBV (Epstein-barr virus)

30
Q

where does the virus replicate in infectious mononucleosis

how does this look on histology

A

B lymphocytes = look large on histology

31
Q

how does EBV spread to cause infectious mononucleosis (glandular fever)

A

saliva (kissing)

32
Q

which group of people get infectious mononucleosis

A

young people

‘mono’ is the kissing disease from mono lol

33
Q

how does glandular fever (infectious mononucleosis) present

A

fever
lymphadenopathy (hence glandular)
pharyngitis

34
Q

what does glandular fever (infectious mononucleosis) look like on examination

A

‘cheesy’ coating on membrane

35
Q

what malignancies are associated with glandular fever (infectious mononucleosis) (2)

A

hodgkins lymphoma

burkitts lymphoma

36
Q

what is the spleen like in infectious mononucleosis ((glandular fever)

lifestyle advice associated with this

A

large

no sports for 6 weeks incase it ruptures

37
Q

2 investigations for infectious mononucleosis (glandular fever)

A

EBV IgM
monospot test

(MONOspot test for MONOnucleosis)

38
Q

treatment of glandular fever (infectious mononucleosis)

A

self limiting in 3 weeks

paracetamol for pain and fever

39
Q

why dont you give amoxicillin for any throat infections

A

may cause a rash (though controversial)

40
Q

if someone has EBV IgM but not had glandular fever how did they acquire the virus

A

infected as an infant

41
Q

which group of people get acute epiglottitis

A

children

42
Q

microbio of acute epiglottitis

A

haem influenzae B

43
Q

is acute epiglottitis common

why

A

no

vaccination against it in babies

44
Q

presentation of acute epiglottis (3)

A

drooling
severe croup/stridor
fever

45
Q

investigations for acute epiglottitis (2)

A 
blood cultures (not swabs bc of colonisation) 
lateral xray - thumb sign
46
Q

treatment of acute epiglottitis (1)

A

ceftriaxone IV

in Children = Ceftriaxone

47
Q

are laryngeal polyps rare

what do you do about them

A

yes

nothing

48
Q

aetiology of throat squamous cell carcinoma in a young non smoker/drinking

A

HPV 16 (or HPV 18)

49
Q

age group affected by HPV squamous cell carcinoma

A

young 20-50

bc sexually active

50
Q

where do HPV squamous cell carcinomas usually occur

A

oropharynx (high up bc of oral sex)

51
Q

how is HPV transmitted (in squamous cell carcinoma)

A

oral sex

52
Q

does someone with HPV squamous cell carcinoma present with pain

A

no

53
Q 
hoarseness
fatigue 
weight loss 
lymphadenopathy 
otalgia 
30 year old 
non smoker/drinker
A

HPV cause squamous cell carcinoma

54
Q

which type of squamous cell carcinoma has better prognosis

A

HPV (not smoking/drinking cause)

55
Q

treatment of HPV cause squamous cell carcinoma

A

chemoradiotherapy

56
Q

if squamous cell carcinoma isnt caused by HPV what is it most likely to be caused by

A

smoking/drinking

57
Q

what is the likely cause of a cancer on the lateral border of the tongue

A

smoking/drinking

58
Q

which type (location) of laryngeal carcinoma has best prognosis

why

A

glottic

presents with hoarseness early bc its on the vocal cords themselves

59
Q

who (risk factors, age and gender) typically get non HPV cause throat squamous cell carcinoma

A

males >50

smoking and drinking

60
Q

where may pain from throat squamous cell carcinoma refer to

A

ear (otalgia)

61
Q

diagnostic investigation for squamous cell carcinoma

A

fibre optic endoscopy with biopsy

62
Q

what stain do you want to use for HPV squamous cell carcinoma

A

brown stain

63
Q

what investigations would you do to look for metastasis in squamous cell carcinoma

A

CXR

PET CT - head, neck, thorax, upper abdo

64
Q

lifestyle modification for smoking/drinking squamous cell carcinoma

A

stop smoking and drinking

65
Q

treatment of smoking/drinking throat squamous cell carcinoma (most likely and alternative)

A

laryngectomy with post op radiotherapy - most likely, need to learn to speak again

chemo - alternative, bad side effects

66
Q

what endocrine disorder can present as tumours in the throat

A

MEN2 paragangliomas

67
Q

aetiology of laryngeal polyps/nodules (3)

A

vocal abuse (singing)
GORD
chronic throat problems

68
Q

bilateral parotitis caused by a virus

A

mumps (paramyxovirus)

69
Q

most common salivary gland tumour location

A

parotic gland

70
Q

is pleomorphic salivary gland tumour benign or malignant?

A

benign (its an adenoma)

71
Q

malignant salivary gland tumour with poor prognosis

A

adenoid cystic carcinoma

72
Q

what ENT cancer is associated with infectious mononucleosis (glandular fever caused by EBV)

A

NASOpharyngela carcinoma

J ENT (11 decks)

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