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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
Treatment of PTA
- ensure airway is secured - drainage - emperic abx (unasyn/clinda IV, augmentin) - antipyretics - analgesics - single dose steriod
26
Complications of untreated PTA
- airway obstruction - internal jugular seeding of infection - pseudo aneurysm of carotid artery - septicemia
27
Rheumatic fever
delayed, non-suppurative sequelae of GABHS pharyngitis involving lesions of joints, heart, SQ tissue and CNS
28
Average age of onset of Rheumatic fever
5-15
29
What is Jones criteria
diagnostic tool for rheumatic fever
30
What do you need for diagnosis of Rheumatic fever
evidence of recent strep infection PLUS 2 major 1 major 2 minor 3 minor (recurrent AF only)
31
Major criteria in Jones criteria
- migratory arthritis - carditis/valvulitis - sydenham chorea - erythema marginatum - subcutaneous nodules
32
Minor criteria in Jones criteria
- arthralgia - fever - elevated ESR or CRP - prolonged PR interval
33
Erythema Marginatum in rheumatic fever
non puritic, serpiginous erythematous eruption to the trunk
34
Pneumotic for remember Jones criteria major sx
``` J- joints (migratory arthritis) O- oh my heart (carditis) N- nodules E- erythema marginatum S- syndenham chorea ```
35
Lab work up for rheumatic fever
non specific - rapid strep - throat culture - anti strep titers - C reactive protein or sed rate
36
Imaging/misc work up for Rheumatic fever
- EKG (prolonged PR) - chest xray (cardiomegaly or CHF) - echo
37
Acute management for rheumatic fever
- Pen VK - aspirin - cortocosteroids - bed rest until fever gone until tests normalize
38
Secondary prophylaxis for rheumatic fever
to prevent recurrence -PCN benzathine q 4 weeks *longer if carditis was present*
39
When does post strep glomerulonephritis appear
1-3 weeks after strep infection (skin or throat)
40
Classic signs of APSGN
- edema - hematuria - hypertension - porteinuria - oliguria
41
Diagnosis of APSGN
- urine dip and microscopy - Sterptozyme test (looks for strep) - rapid strep/throat culture - renal function (increased BUN/Cr)
42
Treatment of APSGN
- treat underlying condition if discovered - mostly supportive therapy - restrict salt/water intake - diuretics - HTN control - limited activity - dialysis if necessary
43
Laryngitis
inflammation of larynx and vocal fold mucosa, edematous vocal cords
44
Causes of acute laryngitis
- viral - bacterial - GERD - environmental - vocal trauma
45
How long does chronic laryngitis last
more than 3 weeks
46
S&S of laryngitis
- preceding URI sx - dysphonia - odynophagia - odynophagia
47
Treatment of laryngitis
symptomatic - voice rest - inhaled humidifier
48
Three major salivary glands
- parotid - submandibular - sublingual
49
What causes sialadenitis
- viral - bacterial - inflammatory/autoimmune - stone - dehydration - neoplastic
50
Two most common causes of viral sialadenitis
Mumps and HIV
51
Work up for sialadenitis
- physical exam - mumps titer - HIV RNA - if unclear do ultrasound, CT of face/neck, sialadenoscopy
52
S&S of bacterial sialadenitis
- sudden onset of pain - unilateral - firm and tender - expression of pus
53
Most common pathogen for bacterial sialadenitis
staph aureu
54
Treatment for bacterial sialadenitis
- abx (nafcillin, dicloxacillin, augmentin) - massage of duct - warm compress - sialogogues - surgical drain if abscessed

Clin Med Exam II (11 decks)

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