Pharyngitis

Question 1

Define pharyngitis

Answer 1

inflammed pharyngeal mucosal
infected nasopharynxl or oropharynx
Can be acute or chronic

Question 2

What are the causative agents of acute pharyngitis

Answer 2

Rhinovirus
Adenovirus
Coronavirus
Group A beta Hemolytic streptococcus GABHS
Streptococcus pyogens
H. influenzae
Staphylococcus aureus
Neisseria spp (Gonococcal)
ALLERGIES
TRAUMA
TOXINS
NEOPLASM

Question 3

How would you diagnose AP from GABHS

Answer 3

Group A Beta Hemolytic Streptococcal rapid antigen detection test

Question 4

Describe the pathophysiology of pharyngitis

Answer 4

Mucosal invasion
Local inflammation
Increased capillary permeability
Increased swelling and erythema, exudate and fever
Streptococcal infections also produce extracellular toxins

Question 5

Risk factors of pharyngitis

Answer 5

Cigarette smoke
GERD
Common cold and flu

Question 6

Symptoms of viral pharyngitis

Answer 6

Coryza
Cough
Conjunctivitis

Question 7

Symptoms of GABHS pharyngitis

Answer 7

Sore throat
Fever
Concurrent headache/N/V/Abdominal pain
Erythema/inflamed tonsils and pharynx
Exudate or nah
Petichea on soft palate
Scarlatiniform rash
Recent orogenital contact
Lymphadenopathy

Question 8

What is the criteria to GABHS diagnosis

Answer 8

CENTOR
Each item is a point
-Fever
-Tonsillar exudate
-Absence of cough
-Cervical lymphadenopathy

Question 9

Complications of pharyngitis

Answer 9

-Acute rheumatic fever
-Acute glomerulonephritis
-Mastoid it is
-Otitis media
-Peritonsilar abscess
-Rhinosinutis
-Necrotizing fasciitis

Question 10

Physical exams to check for AP

Answer 10

Ability to breathe
Temperature
Hydration
Odynophagia (painful swallowing)
Lymphadenopathy
Hepatosplenomegaly

Question 11

Differential diagnosis

Answer 11

Allergic rhinitis with postnasal drip
Airways obstruction
Neoplasm
GERD
Peritonsilar cellulite
HSV
Scarlet fever

Question 12

Diagnosis

Answer 12

GABHS rapid antigen detection test
Throat culture
Antibiotics given 7 days after onset to prevent rheumatic fever

Question 13

Treatment of pharyngitis considerations

Answer 13

Antibiotics iff confirmed streptococcus infection
Prevents rheumatic fever if given within 7 days of onset
Give steroids if
severe/exudates
airways obstruction
odynophagia

Question 14

How do you treat pharyngitis pharmacologically

Answer 14

1st line
Pen V 250mg/kg q8h kids, q6h adults
Benzathine penicillin I’M stat
Amoxycillin 50mg/kg BID 10 days

ALTERNATIVE
Cephalosporin
Macrolides
Clindamycin

Steroids
Dexamethasone IM stat
Prednisolone