Throat: quinsy, glandular fever, head and neck cancers Flashcards
Define/causes of quinsy?
Also known as peri-tonsillar abscess.
Pus/abscess between tonsil capsule and lateral pharyngeal wall (around the tonsils basically).
Caused by bacteria:
- Group A Strep
- Staphylococcus aureus
Presentation of quinsy?
Unilateral swelling (uni-tonsillar bulge)
Deviated uvula
Hot potato voice (muffled voice)
Sore throat
Dysphagia
Odynophagia
Diagnosis/IVx of quinsy?
Clinical diagnosis ( uni-tonsillar bulge and uvula deviation)
CT scan or US -if physical exam is not definitive.
Management of quinsy?
Broad spectrum abx (IV)
IV fluids
Aspiration -remove abscess
Define/cause of glandular fever? How is it transmitted?
Epstein Barr virus (EBV) viral infection that affects lymph nodes, tonsils, and liver.
Transmitted through saliva and shared items.
- hence it’s also known as “kissing disease”
Presentation of glandular fever?
Prodromal illness
Sore throat
Dysphagia
Lymphadenopathy
Hepatospelnomegaly
Abdominal pain
Fever
Fatigue
Diagnosis/IVx of glandular fever?
Clinical diagnosis
‘Paul Bunnell’ test (MONOSPOT test -heterophile antibodies)
FBC
LFTs
Blood film
Management of glandular fever?
Send to hospital if STRIDOR or DEHYDRATION present.
Supportive:
- rest
- OTC analgesia -for fever and sore throat
Avoid contact sports and heavy lifting for a minimum of one month.
- to minimised risk of splenic rupture.
Avoid kissing, sharing eating/drinking utensils.
What does head and neck cancers refer to?
A diverse group of malignancies that arise in this area.
Most common -squamous cell carcinomas.
Presentation of head and neck cancer?
Hoarseness
Dysphagia
Dyspnoea
Throat pain
Stridor
Trismus
Wt loss
Fever
Night sweats
Painless neck lump
Lymphadenopathy
Tongue ulcers
Diagnosis/IVx of head and neck cancer?
CT/MRI/PET
Biopsies
Blood tests
- FBC
- LFTs
- hormonal assays for endocrine tumours
Management of head and neck cancer?
Surgery
Radiotherapy
Chemotherapy (used in advanced cases)
Targeted therapy
Referral criteria for 2ww suspected laryngeal cancer?
aged ≥45 with:
- Persistent unexplained hoarseness
OR
- unexplained neck lump
Referral criteria for 2ww suspected oral cancer?
Unexplained ulceration in oral cavity for ≥3weeks
OR
Persistent unexplained neck lump
