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HEENT > Throat MDT > Flashcards

Throat MDT Flashcards

1
Q

What is epiglottitis?

A

Inflammation of epiglottis of viral or bacterial origin

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2
Q

Who is predisposed to epiglottis?

A
  • DM patients
  • contact with group A-beta hemolytic streptococci
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3
Q

Physical findings of epiglottitis

A
  • rapidly developing sore throat or odynophagia out of proportion with findings
  • laryngoscopy may find swollen erythematous epiglottis
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4
Q

What would radiologic studies show in epiglottitis?

A

“Thumb sign”

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5
Q

Treatment of epiglottitis

A

Antibiotics
- Ceftriaxone (rocephin)
Steroid
- Dexamethasone

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6
Q

What is leukoplakia?

A

White lesions unable to be removed by rubbing of mucosal surface

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7
Q

What is hyper keratosis?

A

Response to a physical or chemical irritant

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8
Q

What percentage of leukoplakia show dysplastic changes?

A

2%-4%

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9
Q

What predisposing factors can lead to leukoplakia?

A
  • alcohol and tobacco use
  • ill fitting dentures or ill contoured dental restoration
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10
Q

Where is leukoplakia most common?

A

Buccal mucosa (cheeks)

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11
Q

What locations of leukoplakia are associated with malignancy?

A

Floor of mouth, tongue and vermillion border

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12
Q

Signs and sx of leukoplakia

A
  • white or painless lesions that cannot be removed
  • wet finger appearance
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13
Q

What labs should be done for leukoplakia?

A

Refer for biopsy to r/o dysplasia

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14
Q

What treatment is required for leukoplakia?

A

No treatment required

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15
Q

What is peritonsillar abscess?

A

Infection penetrates tonsillar capsule and involves the surrounding tissues

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16
Q

What predisposes a patient to peritonsillar abscess?

A
  • chronic tonsillitis
  • multiple trials of oral antibiotics
  • hx of PTA
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17
Q

Sx and findings of PTA

A
  • hot potato voice
  • cervical lymphadenopathy
  • Uvula deflection
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18
Q

Treatment of PTA

A

Ceftriaxone + Metronidazole
If PCN allergy:
Clindamycin

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19
Q

What procedure must be done to treat PTA?

A

Needle aspiration with 19-21g needle

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20
Q

How deep should needle aspiration be for PTA I&D?

A

No deeper than 1cm due to internal carotid artery

21
Q

Who should PTA be referred to?

A

ER, ENT or Gen surg for I&D

22
Q

What is pharyngitis?

A

Inflammation and infection of the pharynx

23
Q

What is tonsillitis?

A

Inflammation and infection of the tonsils

24
Q

What percentage of office visits are due to pharyngitis/tonsillitis?

A

10%

25
Q

What percentage of outpatient antibiotics are due to pharyngitis/tonsillitis?

A

50%

26
Q

What infection is most concerning for management of pharyngitis/tonsillitis?

A

Group A-B hemolytic streptococcal infection (GABHS)

27
Q

What complication can GABHS lead to?

A

Rheumatic fever

28
Q

What kind of pharyngitis is common after antibiotic treatment or if patient is immunocompromised?

A

Fungal Pharyngitis (candida albicans)

29
Q

How long is the incubation period of GABHS?

A

2-5 days

30
Q

What is the CENTOR criteria?

A
  • Fever over 38C (100.4F)
  • Lymphadenopathy
  • Lack of a cough
  • Pharyngotonsillar exudates
31
Q

What is indicative of shaggy white-purple exudates that often extends into the nasopharynx?

A

Mononucleosis

32
Q

What is indicative of vesicular and petechial pattern on the soft palate?

A

Viral Pharyngitis/Laryngitis

33
Q

What is indicative of white, cheesy exudates?

A

Fungal Pharyngitis/Laryngitis

34
Q

What labs should be done when examining a patient with pharyngitis/laryngitis?

A
  • Rapid Strep
  • Monospot
  • Throat Culture
  • HIV
35
Q

What medications should be given to patients with GABHS?

A

Benzathine PCN 1.2million units IM
PCN VK 500mg PO BID/TID for 10 days
Dicloxacillin 250-500mg PO QID
Augmentin 500mg PO TID
Azithromycin 500mg daily for 3 days

36
Q

What can a patient do that can also assist with viral laryngitis/pharyngitis?

A

Warm, salt water gargles

37
Q

What is paradise criteria?

A

Referral for tonsillectomy
- 3 or more episodes in each of 3 years
- 5 or more episodes in each of 2 years
- 7 or more episodes in one year

38
Q

What is sialadentitis?

A

Dutcal obstruction often by mucus plug or stone followed by salvary stasis and secondary infection

39
Q

What glands does acute bacterial sialdentitis commonly affect?

A

Parotid or submandibular glands

40
Q

What is the most common organism from purulent discharge of sialadentitis?

A

S aureus

41
Q

What predisposes a patient to siladentitis?

A
  • dehydration
  • chronic illness
  • chronic periodontitis
42
Q

Sx and physical findings of sialadentitis

A
  • acute swelling of gland
  • pus can often be massaged from the duct
  • increased pain and swelling with meals
43
Q

Radiologic studies for sialadentitis

A
  • Ultrasound
  • CT
44
Q

Medications for sialadentitis

A

Antibiotics
- Nafcillin
- Oxacillin
PO Antibiotics if patient stable
- Clindamycin
- Cipro

45
Q

Conservative treatment of sialadentitis

A
  • hydration
  • warm compress
  • sialogogues
  • massage gland
46
Q

What is tonsilloliths?

A

Tonsil stones, soft aggregates of bacterial and cellular debris that form in tonsillar crypts, crevices

47
Q

Signs and sx of tonsilloliths

A
  • may be asymptomatic
  • Putrid breath
  • Metallic taste
48
Q

Treatment of tonsiloliths

A
  • no treatment if asymptomatic
  • irrigation
  • tonsillectomy maybe indicated

HEENT (9 decks)

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