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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
treatment of diphtheria
antitoxin | antibiotics - penicillin
26
is diphtheria common
no bc of vaccination
27
how does candida/oral thrush look
white patches on raw red mucosa | in throat/mouth (not just throat like diphtheria)
28
another name for infectious mononucleosis
glandular fever
29
virus causing infectious mononucleosis
EBV (Epstein-barr virus)
30
where does the virus replicate in infectious mononucleosis how does this look on histology
B lymphocytes = look large on histology
31
how does EBV spread to cause infectious mononucleosis (glandular fever)
saliva (kissing)
32
which group of people get infectious mononucleosis
young people | 'mono' is the kissing disease from mono lol
33
how does glandular fever (infectious mononucleosis) present
fever lymphadenopathy (hence glandular) pharyngitis
34
what does glandular fever (infectious mononucleosis) look like on examination
'cheesy' coating on membrane
35
what malignancies are associated with glandular fever (infectious mononucleosis) (2)
hodgkins lymphoma | burkitts lymphoma
36
what is the spleen like in infectious mononucleosis ((glandular fever) lifestyle advice associated with this
large no sports for 6 weeks incase it ruptures
37
2 investigations for infectious mononucleosis (glandular fever)
EBV IgM monospot test (MONOspot test for MONOnucleosis)
38
treatment of glandular fever (infectious mononucleosis)
self limiting in 3 weeks | paracetamol for pain and fever
39
why dont you give amoxicillin for any throat infections
may cause a rash (though controversial)
40
if someone has EBV IgM but not had glandular fever how did they acquire the virus
infected as an infant
41
which group of people get acute epiglottitis
children
42
microbio of acute epiglottitis
haem influenzae B
43
is acute epiglottitis common why
no vaccination against it in babies
44
presentation of acute epiglottis (3)
drooling severe croup/stridor fever
45
investigations for acute epiglottitis (2)
``` blood cultures (not swabs bc of colonisation) lateral xray - thumb sign ```
46
treatment of acute epiglottitis (1)
ceftriaxone IV | in Children = Ceftriaxone
47
are laryngeal polyps rare what do you do about them
yes nothing
48
aetiology of throat squamous cell carcinoma in a young non smoker/drinking
HPV 16 (or HPV 18)
49
age group affected by HPV squamous cell carcinoma
young 20-50 | bc sexually active
50
where do HPV squamous cell carcinomas usually occur
oropharynx (high up bc of oral sex)
51
how is HPV transmitted (in squamous cell carcinoma)
oral sex
52
does someone with HPV squamous cell carcinoma present with pain
no
53
``` hoarseness fatigue weight loss lymphadenopathy otalgia 30 year old non smoker/drinker ```
HPV cause squamous cell carcinoma
54
which type of squamous cell carcinoma has better prognosis
HPV (not smoking/drinking cause)
55
treatment of HPV cause squamous cell carcinoma
chemoradiotherapy
56
if squamous cell carcinoma isnt caused by HPV what is it most likely to be caused by
smoking/drinking
57
what is the likely cause of a cancer on the lateral border of the tongue
smoking/drinking
58
which type (location) of laryngeal carcinoma has best prognosis why
glottic presents with hoarseness early bc its on the vocal cords themselves
59
who (risk factors, age and gender) typically get non HPV cause throat squamous cell carcinoma
males >50 | smoking and drinking
60
where may pain from throat squamous cell carcinoma refer to
ear (otalgia)
61
diagnostic investigation for squamous cell carcinoma
fibre optic endoscopy with biopsy
62
what stain do you want to use for HPV squamous cell carcinoma
brown stain
63
what investigations would you do to look for metastasis in squamous cell carcinoma
CXR | PET CT - head, neck, thorax, upper abdo
64
lifestyle modification for smoking/drinking squamous cell carcinoma
stop smoking and drinking
65
treatment of smoking/drinking throat squamous cell carcinoma (most likely and alternative)
laryngectomy with post op radiotherapy - most likely, need to learn to speak again chemo - alternative, bad side effects
66
what endocrine disorder can present as tumours in the throat
MEN2 paragangliomas
67
aetiology of laryngeal polyps/nodules (3)
vocal abuse (singing) GORD chronic throat problems
68
bilateral parotitis caused by a virus
mumps (paramyxovirus)
69
most common salivary gland tumour location
parotic gland
70
is pleomorphic salivary gland tumour benign or malignant?
benign (its an adenoma)
71
malignant salivary gland tumour with poor prognosis
adenoid cystic carcinoma
72
what ENT cancer is associated with infectious mononucleosis (glandular fever caused by EBV)
NASOpharyngela carcinoma

J ENT (11 decks)

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