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ENT > Throat Infections > Flashcards

Throat Infections Flashcards

1
Q

What is diptheria?

A

Highly contagious and potentially fatal throat infection by corynebacterium diptheriae

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2
Q

Why is diptheria so life threatening?

A

Corynebacterium diptheriae produces cardiotoxic and neurotoxic endotoxins

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3
Q

How does diptheria present?

A

Severe sore throar

Grey-white pseudomembrane across pharynx

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4
Q

What is infectious mononucleosis?

A

Viral throat infection caused by Epstein-Barr virus

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5
Q

How does infectious mononucleosis usually present?

A

Commonly in young adults (kissing)

Fever

Sore throat

Lymphadenopthy

Palatal petechial haemorrhages

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6
Q

How does infectious mononucleosis present in children under 10?

A

Often asymptomatic

Patients still develop Epstein-Barr virus IgM

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7
Q

What blood test can diagnose infectious mononucleosis?

A

Monospot test
Paul-Bunnel test

Test for heterophile antibodies

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8
Q

What does a positive Epstein-Barr virus IgM test show?

A

Previous exposure to the virus

It is not diagnostic of infectious mononucleosis as immunity may have developed in asymptomatic infection in childhood

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9
Q

What would infectious mononucleosis show on blood film?

A

Atypical lymphocytes “activated cytotoxic T lymphocytes”

(larger, irregular cytoplasm/nucleus, stippled cytoplasm)

Seen in any viral infection but large percentage is pathogneumonic of infectious mononucleosis

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10
Q

What are CRP levels like in infectious mononucleosis?

A

Low CRP (<100)

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11
Q

Name 5 blood tests which can be useful in diagnosing infectious mononucleosis and what they show.

A

Monospot/Paul-Bunnel tests - heterophile antibodies

Epstein-Barr IgM - positive if previous infection

Blood film - atypical lymphocytes

CRP - low (<100)

Liver function tests - raised ALT

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12
Q

How is infectious mononucleosis treated?

A

Supportively

Self limiting but prolonged

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13
Q

What 2 medications should not be prescribed to someone with infectious mononucleosis and why?

A

Amoxicillin - causes generalised macular rash

Antivirals - no clinical benefit

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14
Q

Patient with infectious mononucleosis presents with sudden onset severe stomach pain. What has occurred?

A

Splenic rupture (surgical emergency)

50% of patients have splenomegaly but rupture is very rare

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15
Q

What condition are people with infectious mononucleosis at increased risk of?

A

Lymphoma

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16
Q

What conditions must be ruled out in a pregnant women presenting with infectious mononucleosis symptoms and why?

A

Cytomegalovirus
Toxoplasmosis

Can cause foetal damage

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17
Q

Patient presents with infectious mononucleosis symptoms. Blood tests are performed and the Epstein-Barr virus IgM has come back negative.
What blood test do you do now?

A

HIV antibody blood test

18
Q

What is oral candidiasis?

A

Oral yeast infectious with Candida species, most commonly candida albicans

19
Q

How does oral candidiasis present?

A

White patches covering raw mucous memebranes in throat/mouth

20
Q

What are risk factors for developing oral candidiasis?

A

Immunosuppression

Inappropriate steroid inhaler use

False teeth

Recent antibiotics

21
Q

How is oral candidiasis treated?

A

Nystatin

22
Q

What is tonsillitis?

A

Inflammation of the tonsils usually usually caused by viral infection

23
Q

What causes tonsillitis?

A

Usually a viral infection

Streptococcus pyogenes is rarer that viral infection but causes a more severe infection with more complications

24
Q

How does tonsillitis present?

A

Fever

Sore throat

Inflamed tonsils

25
Q

How do you clinically assess whether tonsillitis is caused by a viral infection or by streptococcus pyogenes?

A

Centor criteria

  • tonsillar exudate
  • tender cervical lymphadenopathy
  • history of fever
  • absence of cough

The more of the above criteria the patient has, the more likely it is that the tonsillitis is caused by streptococcus pyogenes

26
Q

How is tonsillitis generally managed?

A

Supportively (fluids, analgesia and rest)

Antibiotics if more 2/3 or more of Centor criteria

27
Q

How do you know whether to prescribe antibiotics in tonsillitis?

A

Centor criteria

  • tonsillar exudate
  • tender cervical lymphadenopathy
  • history of fever
  • absence of cough

If they have 2/3 or more of above criteria, prescribe antibiotics

28
Q

What antibiotics are used to treat tonsillitis?

A

Penicillin
or
Clarithromycin

29
Q

What should not be prescribed to a patient with tonsillitis and why?

A

Amoxilcillin (can cause rash if it is actually infectious mononucleosis)

30
Q

What are the criteria for tonsillectomy?

A

> 7 episodes in last year
5 episodes in last 2 years
3 episodes in last 3 years

31
Q

Name 3 complications of tonsillitis.

A

Otitis media

Peri-tonsillar abscess (quinsy)

Infectious mononucelosis

32
Q

How is quinsy treated?

A

Aspiration and antibiotics (penicillin or clindamycin)

33
Q

18 year old presents with tonsillitis. He is managed appropriately but doesn’t respond to treatment and is still ill after 2 weeks.

What blood test do you do?

A

Monospot/Paul-Bunnel test

for infectious mononucleosis

34
Q

Name 2 complications of streptococcal sore throat and how they present.

A

Rheumatic fever
- fever, arthritis and pancarditis

Glomerulonephritis
- haematuria, albuminuria, gradual onset oedema

35
Q

What is epiglottitis?

A

Inflammation and swelling of the epiglottis causing airway obstruction (medical emergency)

36
Q

What causes epiglottitis?

A

Heamophilus influenzae type B

37
Q

How does epiglottitis present?

A

Acute onset fever, sore throat, drooling and stridor in children

38
Q

How investigations are done in the assessment of epiglottitis?

A

Blood cultures

not throat swab as it can cause muscle spasm which further obstructs airway

39
Q

How is epiglottitis treated?

A

Intubation and ceftriaxone

40
Q

What is mumps?

A

Viral infection caused by mumps paramyxovirus

41
Q

How does mumps present?

A

Fever/myalgia/fatigue followed by parotitis

associated with orchitis

42
Q

What can untreated mumps cause?

A

Meningitis

ENT (7 decks)

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