Week 1

Question 1

what is another word for sore throat or inflammation of the pharynx

Answer 1

pharyngitis

Question 2

what classifies as acute pharyngitis

Answer 2

less than 2 weeks duration

Question 3

what classifies as chronic pharyngitis

Answer 3

more than 2 weeks duration

Question 4

what are the 2 causes of pharyngitis? and which is more common?

Answer 4

infectious and non-infectious causes, infectious is more common

Question 5

Infectious causes of pharyngitis is broken down into 2 categories which is? which one is more common?

Answer 5

viral and bacterial, viral is more common

Question 6

what is the most common cause of viral pharyngitis?

Answer 6

common cold (rhinovirus and coronavirus = 25%)

Question 7

what is the most common cause of bacterial pharyngitis?

Answer 7

Group A Beta-hemolytic streptococci

Question 8

what is a red flag?

Answer 8

signs and symptoms found in the patient history and clinical examination that may indicate possible serious underlying pathology

Question 9

what is acute epiglottitis?

Answer 9

inflammation of epiglottis and adjacent tissues

Question 10

what is the bacterial infection that causes acute epiglottitis

Answer 10

Haemophilus influenzae

Question 11

is antibiotic therapy required for acute epiglottitis?

Answer 11

yes

Question 12

What is the 4Ds? (hint: key clinical presentation for acute epiglottitis)

Answer 12

• dysphagia
• drooling
• dysphonia
• distress

Question 13

what is the most common deep infection of head and neck?

Answer 13

peritonsillar abscess (Quinsy)

Question 14

what is the key characteristic of peritonsillar abscess?

Answer 14

severe unilateral sore throat

Question 15

T or F: Peritonsillar Abscess patients may have trismus (lockjaw) and a rancid breath

Answer 15

true

Question 16

what is retropharyngeal abscess?

Answer 16

retropharyngeal edema due to cellulitis and supporative adenitis of lymph nodes in retropharyngeal space

Question 17

what are 3 red flag conditions for pharyngitis?

Answer 17

• acute epiglottits
• peritonsillar abscess
• retropharyngeal abscess

Question 18

what is a strong indication of infectious cause of pharyngitis?

Answer 18

fever

Question 19

T or F: viral causes of pharyngitis do not require antibiotic therapy unless there is a secondary bacterial infection

Answer 19

true

Question 20

what is the bacteria that causes streptococcal pharyngitis?

Answer 20

group A beta-hemolytic streptococci

Question 21

what are the non-suppurative complications from strep throat?

Answer 21

• acute rheumatic fever (ARF)
• poststreptococcal glomerulonephritis
• Pediatric autoimmune neurophsychiatric disorder assocated with group A streptococcal (PANDA)

Question 22

cause of ARF?

Answer 22

cross-reactive antibodies produced in reaction to GABHS infection

Question 23

what is poststreptococcal glomerulonephritis

Answer 23

injury to the glomerulus due to deposition of immune complexes and circulating autoantibodies

Question 24

what is pediatric autoimmune neuropsychiatric disorder associated to Group A strep?

Answer 24

abrupt onset of severe exacerbations of obsessive-compulsive type behaviours or tics in children following GABHS infection, thought to be due to antibodies cross-reacting with regions in the basal ganglia

Question 25

what are some suppurative complications?

Answer 25

- peritonsillar abscess - retropharyngeal abscess - otitis media - mastoiditis - cervical lymphadenitis - meningitis

Question 26

what is the test that can help predict the probability of streptococcal pharyngitis and guide clinical decision making called?

Answer 26

Modified Centor Score (McIssac Score)

Question 27

what was newly added to the modified centor score and was not on the original centor score?

Answer 27

age

Question 28

what are the 5 things on the centor score? what is the Mnemonic

Answer 28

M-CENTOR Must be older than 3 years Cough Exudates on tonsils Nodes - anterior cervial Temperature (>38) Only young (<15 years old) Rarely elder (>45 Years old)

Question 29

what do you do when you have a positive and negative rapid antigen test?

Answer 29

Positive: patient is treated without follow-up cutures Negative: throat culture is obtained to confirmed strep

Question 30

what is the disadvantage to rapid antigen detection test?

Answer 30

cannot distinguish between carrier of GABHS and active infection, nor does it indicate antibiotic susceptibility or strain virulence

Question 31

what is the gold standard for diagnosis of streptococcal pharyngitis?

Answer 31

throat culture

Question 32

T or F: most steptococcal pharyngitis cases are self-limiting 7-10 days even without antibiotics

Answer 32

true

Question 33

what is the antibiotic therapy of choice for strep?

Answer 33

penicillin (unless patient has allergy)

Question 34

what is "kissing disease"?

Answer 34

infectious Mononucleosis

Question 35

is mono viral or bacterial? and what is the most common cause of it?

Answer 35

viral most common cause: Epstein-Barr virus (EBV)

Question 36

what are the main indicators if a person has mononucleosis?

Answer 36

posterior cervical lymph nodes swollen Splenomegaly (ruptured spleen)

Question 37

what is the test used to diagnose mononucleosis?

Answer 37

monospot test