throat ID Flashcards
what causes gingivostomatitis
herpes simplex
symptoms gingivostomatitis
systemic upset, lymph nodes, lethargy // ulcers on lips, buccal mucosa, hard palate
what causes cold sores
usually HSV1 (can be HSV2)
mx gingivostomatitis
oral aciclovir + chlorhexidine mouthwash
mx cold sores
topical aciclovir
diagnosis HSV
swab + PCR
what causes herpangina
enterovirus eg Coxsackievirus
sympoms herpangina
ulcers on soft palate
what causes hand, foot, mouth disease
Coxsackievirus a16 + enterovirus 71
symptoms hand, foot, mouth
mild systemic upset, sore throat, fever // oral ulcers // vesicles on hands and feet
mx hand, foot, mouth
symptomatic // no need to stay off school
symptoms oral candida
white, lacy patches on mucous membranes which wipe away
Risk factors oral candida
diabetes, inhaled steroids, abx, immunosuppressed, smokers
mx oral candida
nyastin or fluconazole
usual mx for sore throat
no swab, paracetamol + ibuprofin
indication for abx sore throat
systemic upset // unilateral tonsillitis // history rheumatic fever // immunocompromised // centor or feverPAIN indicate
centor criteria for bacterial sore throat
need 3 or 4 for abx // pus, lymph nodes, fever, no cough
feverPAIN for bacterial sore throat
need 4 or 5 // fever, pus, attend rapidly (3 days), inflamed tonsils, no cough
most common organism tonsillitis
strep pyogenes
mx tonsilitis
pen V (or clarithryomycin) for 7-10 days
complications tonsillitis
otitis media // quinsy // rheumatic fever // glomerulonephritis
indications tonsillectomy
5 episodes a year // 10 in past 2 years // 9 in past 3 years // disabling // recurrent febrile convulsions // airway obstruction // unresponsive quinsy
mx for all post-tonsillectomy bleeding
refer to ENT
when does primary post-tonsillectomy haemorrhage occur + what mx
6-8 hours –> return to theatre
when does secondary post-tonsillectomy haemorrhage occur + what is the problem
5-10 days // infection –> abx
symptoms + signs quinsy
severe pain (unilateral) // uvula deviates to OTHER side // trismus // reduced neck mobility
invx quinsy
ENT
mx quinsy
needle aspiration/ drainage + IV abx // consider tonsillectomy
what causes glandular fever
EBV (human herpes 4 - HHV4)
triad glandular fever
sore throat + lymph + pyrexia
other symptoms glandular fever
malaise, anorexia, headache // palate petechia // hepatitis
invx glandular fever
LFT - raised ALT // atypical lymphocytes // haemolytic anaemia
what can cause haemolytic aneamia glandular fever
cold agglutins (IgM)
what abx is avoided in glandular fever
amoxicillin –> itchy rash
diagnosis glandular fever
heterophil antibody test (monospot)
mx glandular fever
supportive // avoid contact sports for 4 weeks to avoid splenic rupture
what causes diptheria
gram +ive Corynebacterium diphtheriae –> exotoxin
presentation diptheria
recent visit to eastern europe // sore throat + grey membrane at back of throat // large cervical lymph nodes // heart block
invx diptheria
culture –> tellurite agar or loefflers media
mx diptheria
IM penicillin // antitoxin
what causes mumps
RNA paromyxovirus
spread + incubation mumps
droplets, incubation 14-21 days, infective 7 days before + 9 days after parotid swelling
symptoms mumps
fever, malaise, muscle pain, parotid swelling (unilateral –> bilateral), earache, pain on eating
mx mumps
(prevention = MMR vaccine) // paracetamol // NOTIFIABLE disease
complications mumps
orchitis // hearing loss // encephalitis // pancreatitis
what is lemierres syndrome
infectious thrombophlebitis of internal jugula
what usually causes Lemierre’s syndrome
bacterial throat –> peritonislar abscess
organism Lemierre’s syndrome
Fusobacterium necrophorum
symptoms Fusobacterium necrophorum
sore throat –> neck pain, tenderness, stiffness + fever, rigor
complication Fusobacterium necrophorum
septic PE
