Throat Problems Flashcards
viral causes of acute tonsilitis
EBV rhinovirus influenza parainfluenza enterovirus adenovirus
bacterial causes of acute tonsilitis
strep pyogenes (GABHS)
risks in strep pyogenes
rheumatic fever
GM
presentation of viral tonsilitis
malaise sore throat temperature able to undertake normal activity possible lymphadenopathy lasts 3-4 days
presentation of bacterial tonsilitis
systemic upset fever odynophagia halitosis unable to work lymphadenopathy lasts a week
CENTOR criteria for tonsilitis
history of fever
tonsillar exudates
tender anterior cervical lymphadenopathy
absence of cough
<15 add 1 point and >44 subtract 1 point
when should antibiotics be given in tonsilitis?
score on CENTOR criteria of 4-5
supportive management of tonsilitis
eat
drink
rest
analgesia (paracetamol, NSAIDs)
antibiotic management of tonsilitis
penicillin 10 days (clarithromycin if allergic)
surgery if 7 cases in 1 year
what is peritonsillar abscess a complication of?
tonsilitis
what is a peritonsillar abscess?
bacteria becomes lodged in posterior capsule
presentation of peritonsillar abscess
3-7 days acute tonsilitis
unilateral throat pain/ odynophagia
trismus (reduced opening of jaw)
tonsils and uvula displaced (palate bulges out, so tonsil is no longer seen and concavity of palate is lost)
management of peritonsillar abscess
antibiotics
two causes of obstructive hyperplasia
- adenoids
2. tonsils
presentation of obstructive hyperplasia caused by adenoids
obligate mouth breathing hypo-nasal voice snoring sleep disturbance AOM/OME
presentation of obstructive hyperplasia caused by tonsils
snoring
muffled voice
sleep disturbance
dysphagia
what is infectious mononucleosis?
glandular fever caused by EBV
presentation of infectious mononucleosis
gross tonsillar enlargement with membrane exudates cervical and generalised lymphadenopathy palatal petechial haemorrhages jaundice hepatosplenomegaly
diagnosis of infectious mononucleosis
FBC= atypical lymphocytes, low CRP <100 and deranged LFTs
monospot or paul-bunnell test
management of infectious mononucleosis
supportive
systemic steroids if failing
what should never be given to infectious mononucleosis?
amoxicillin
results in macular rash
what is epiglottitis?
inflammation of the epiglottis
what is the most common cause of epiglottitis?
H. influenza B
presentation of epiglottitis
severe sore throat
drooling saliva
pyrexia
can have stridor
diagnosis of epiglottitis
examination of oral cavity is normal
management of mild epiglottitis
supportive
nebulisers (adrenaline/ saline)
steroids
management of severe epiglottitis
antibiotics
intubation
ventilation
tracheostomy
causes of recurrent respiratory papillomatosis
HPV6 and 11
