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Clin Med Exam II > Throat infections > Flashcards

Throat infections Flashcards

1
Q

Tonsillitis

A

inflammation of the palatine tonsils

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2
Q

Pharyngitis

A

inflammation of any structure of the pharynx including adenoids and lingual tonsils

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3
Q

Causes of viral tonsillitis/pharyngitis

A
  • rhino virus
  • EBV
  • adenovirus
  • coronovirus
  • influenza A/B
  • acute retroviral syndrome
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4
Q

Causes of bacterial tonsillitis/pharyngitis

A
  • group A beta hemolytic strep
  • diptheria
  • neisseria gonorrhoeae
  • mycoplasma pneumoniae
  • chlamydia pneumoniae
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5
Q

S&S bacterial tonsillitis/pharyngitis

A
  • lack coryza, cough or other URI sx
  • sudden onset sore throat
  • anterior LAD
  • fever
  • petecchiae of soft palate
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6
Q

S&S viral tonsillitis/pharyngitis

A
  • coryza
  • cough
  • malaise
  • fatigue
  • hoarseness
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7
Q

Diptheria

A

dense grey pseudomembrane covering the tonsils

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8
Q

Scarlet fever

A

aka. GABHS pharyngitis
- fever
- strawberry tongue
- sandpaper like rash on trunk and armpits

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9
Q

What do you need to differentiate viral and bacterial tonsillitis/pharyngitis

A

HISTORY

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10
Q

Clinical diagnosis of GABHS

A

Centor criteria

  • fever
  • anterior cervical lymphadenopathy
  • tonsillar exudate
  • absence of cough

score:
0-1 no further testing
2-3 confirm vis RAPDT
4 treat for strep

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11
Q

What is the gold standard for diagnosis of GABHS

A

throat culture

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12
Q

Other ways to diagnose viral tonsillitis/pharyngitis

A
  • most etiologies there is no testing available
  • rapid influenza test
  • tests for EBV (mono)
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13
Q

Other ways to diagnose bacterial pharyngitis/tonsillitis

A

GC throat

diptheria swab

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14
Q

Treatment of viral pharyngitis/tonsillitis

A

SUPPORTIVE

- +/- single dose of decadron

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15
Q

Treatment of bacterial (GABHS) tonsillitis/pharyngitis in adults

A

Pen Vk PO

Penicillin G Benzathine

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16
Q

Treatment of bacterial (GABHS) tonsillitis/pharyngitis in children

A

Pen Vk

Amoxicillin

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17
Q

Peritonsillar abscess

A

collection of pus located between the capsule of palatine tonsil and pharyngeal muscle

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18
Q

Common location of PTA

A

superior pole of the tonsil

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19
Q

PTA, unilater or bilateral

A

bilateral

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20
Q

Development of PTA

A

tonsillitis/pharyngitis–>cellulitis–>phlegmon–>abscess

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21
Q

What causes a PTA

A

-usually microbial
GABHS most common
-staph aureus, neisseria, corynebacterium

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22
Q

Symptoms of PTA

A
  • severe sore throat (usually unilateral)
  • fever
  • ipsilateral ear pain
  • fatigue
  • irritability
  • decreased PO intake
  • trismus
  • neck pain with movement
23
Q

Signs of PTA

A
  • muffled/”hot potato” voice
  • unilateral swollen and fluctuant tonsil with contralateral deviation of uvula
  • pooling of saliva/drooling
  • trismus
  • neck swelling
  • fever
  • bad breath
  • erythema or exudate of the tonsil
24
Q

Diagnostics for PTA

A

CLINICALLY

  • CT neck with IV contast (best imaging)
  • inta oral ultrasound
  • lateral soft tissue (exclude other pathologies)
25
Q

Treatment of PTA

A
  • ensure airway is secured
  • drainage
  • emperic abx (unasyn/clinda IV, augmentin)
  • antipyretics
  • analgesics
  • single dose steriod
26
Q

Complications of untreated PTA

A
  • airway obstruction
  • internal jugular seeding of infection
  • pseudo aneurysm of carotid artery
  • septicemia
27
Q

Rheumatic fever

A

delayed, non-suppurative sequelae of GABHS pharyngitis involving lesions of joints, heart, SQ tissue and CNS

28
Q

Average age of onset of Rheumatic fever

A

5-15

29
Q

What is Jones criteria

A

diagnostic tool for rheumatic fever

30
Q

What do you need for diagnosis of Rheumatic fever

A

evidence of recent strep infection PLUS

2 major
1 major 2 minor
3 minor (recurrent AF only)

31
Q

Major criteria in Jones criteria

A
  • migratory arthritis
  • carditis/valvulitis
  • sydenham chorea
  • erythema marginatum
  • subcutaneous nodules
32
Q

Minor criteria in Jones criteria

A
  • arthralgia
  • fever
  • elevated ESR or CRP
  • prolonged PR interval
33
Q

Erythema Marginatum in rheumatic fever

A

non puritic, serpiginous erythematous eruption to the trunk

34
Q

Pneumotic for remember Jones criteria major sx

A 
J- joints (migratory arthritis)
O- oh my heart (carditis)
N-  nodules 
E- erythema marginatum
S- syndenham chorea
35
Q

Lab work up for rheumatic fever

A

non specific

  • rapid strep
  • throat culture
  • anti strep titers
  • C reactive protein or sed rate
36
Q

Imaging/misc work up for Rheumatic fever

A
  • EKG (prolonged PR)
  • chest xray (cardiomegaly or CHF)
  • echo
37
Q

Acute management for rheumatic fever

A
  • Pen VK
  • aspirin
  • cortocosteroids
  • bed rest until fever gone until tests normalize
38
Q

Secondary prophylaxis for rheumatic fever

A

to prevent recurrence
-PCN benzathine q 4 weeks

longer if carditis was present

39
Q

When does post strep glomerulonephritis appear

A

1-3 weeks after strep infection (skin or throat)

40
Q

Classic signs of APSGN

A
  • edema
  • hematuria
  • hypertension
  • porteinuria
  • oliguria
41
Q

Diagnosis of APSGN

A
  • urine dip and microscopy
  • Sterptozyme test (looks for strep)
  • rapid strep/throat culture
  • renal function (increased BUN/Cr)
42
Q

Treatment of APSGN

A
  • treat underlying condition if discovered
  • mostly supportive therapy
    • restrict salt/water intake
    • diuretics
    • HTN control
    • limited activity
    • dialysis if necessary
43
Q

Laryngitis

A

inflammation of larynx and vocal fold mucosa, edematous vocal cords

44
Q

Causes of acute laryngitis

A
  • viral
  • bacterial
  • GERD
  • environmental
  • vocal trauma
45
Q

How long does chronic laryngitis last

A

more than 3 weeks

46
Q

S&S of laryngitis

A
  • preceding URI sx
  • dysphonia
  • odynophagia
  • odynophagia
47
Q

Treatment of laryngitis

A

symptomatic

  • voice rest
  • inhaled humidifier
48
Q

Three major salivary glands

A
  • parotid
  • submandibular
  • sublingual
49
Q

What causes sialadenitis

A
  • viral
  • bacterial
  • inflammatory/autoimmune
  • stone
  • dehydration
  • neoplastic
50
Q

Two most common causes of viral sialadenitis

A

Mumps and HIV

51
Q

Work up for sialadenitis

A
  • physical exam
  • mumps titer
  • HIV RNA
  • if unclear do ultrasound, CT of face/neck, sialadenoscopy
52
Q

S&S of bacterial sialadenitis

A
  • sudden onset of pain
  • unilateral
  • firm and tender
  • expression of pus
53
Q

Most common pathogen for bacterial sialadenitis

A

staph aureu

54
Q

Treatment for bacterial sialadenitis

A
  • abx (nafcillin, dicloxacillin, augmentin)
  • massage of duct
  • warm compress
  • sialogogues
  • surgical drain if abscessed

Clin Med Exam II (11 decks)

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