1: Laryngitis and Epiglottitis

Question 1

What is laryngitis

Answer 1

Inflammation of the larynx

Question 2

How can laryngitis be divided

Answer 2

Acute and Chronic

Question 3

What is acute laryngitis

Answer 3

Less than 3W

Question 4

What is chronic laryngitis

Answer 4

More than 3W

Question 5

What causes acute laryngitis most commonly

Answer 5

Viral Infection

Question 6

What are two other causes of acute laryngitis

Answer 6

Bacterial

Systemic

Question 7

What is the most common cause of chronic laryngitis

Answer 7

GORD

Question 8

What are two other causes of chronic laryngitis

Answer 8

Smoking

Post-nasal drip (Viral)

Question 9

What is reinke’s oedema

Answer 9

Type of chronic laryngitis seen in smokers. Where due to poor lymphatic drainage - they have oedema of the vocal cords

Question 10

How does laryngitis present clinically

Answer 10

Hoarse voice 
Dry cough
Dysphasia
Fever 
Painful lymphadenopathy

Question 11

What is a common feature of laryngitis in children

Answer 11

Stridor in children

Question 12

How is laryngitis usually diagnosed

Answer 12

Clinically

Question 13

What is second-line investigation for laryngitis

Answer 13

Laryngoscopy

Question 14

What is the management of laryngitis

Answer 14

• Vocal rest
• Smoking cessation
• Antibiotics if suspect bacterial infection

Question 15

What is epiglottis

Answer 15

Inflammation of the epiglottis and surrounding tissue

Question 16

What age does epiglottitis occur

Answer 16

2-4

Question 17

What causes epiglottitis

Answer 17

Haemophillus Influenza B

Question 18

What are two risk factors for epiglottitis

Answer 18

• Unvaccinated

- Immunocompromised

Question 19

Explain clinical presentation of epiglottitis

Answer 19

• Tripod position + resp distress
• Dysphagia and drooling
• Fever (38-40)
• Muffled voice
• No cough

Question 20

Why is epiglottitis now rare

Answer 20

Due to haemophilluis Influenza B being part of the immunisation schedule

Question 21

Explain investigation of epiglottis

Answer 21

If suspect epiglottitis do not examine their mouth as this can lead to airway obstruction. Refer straight to ENT

Question 22

What is first line management for epiglottitis

Answer 22

• Neb adrenaline
• IV Dexamethasone
• IV antibiotics
• IV Fluids
• Take to theatre for examination under anaesthesia and intubation

Question 23

What may be seen on pharyngoscopy in epiglottitis

Answer 23

Cherry-red epiglottis

Question 24

What may be seen on lateral x-ray in epiglottitis

Answer 24

Thumb-print sign

Question 25

What is complication of epiglottis

Answer 25

Respiratory arrest

Question 26

Define stridor

Answer 26

High-pitch inspiratory breathing caused by obstruction of larynx or large airways

Question 27

What does inspiratory stridor usually indicate

Answer 27

Laryngeal obstruction

Question 28

What does expiratory stridor usually indicate

Answer 28

Tracheobronchial obstruction

Question 29

What is concerning about stridor

Answer 29

All stridor is a red-flag. Particularly concerning is when volume of stridor decreases - as this means individual is suffering from airway obstruction

Question 30

What are 4 causes of stridor in children

Answer 30

Croup Epiglottitis Laryngomalacia Foreign Object

Question 31

What is the most common cause of acute stridor in infants

Answer 31

Croup

Question 32

How will inhaled foreign body present

Answer 32

Repeated coughing prior to onset stridor

Question 33

What is laryngomalacia

Answer 33

Congenital anomaly of the larynx

Question 34

How will laryngomalacia present

Answer 34

New-onset stridor at 4W