Flashcards in 2-Nose and sinus Deck (81)
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1
What causes acute pharyngitis
mostly VIRAL
but can be due to GABHS
2
What are symptoms of acute pharyngitis
sore throat
fever
HA
malaise
adenopathy
URI
3
What are physical exam findings of acute pharyngitis
erythema
tonsillar hypertrophy
purulent exudate
tender ant/ nodes
palatal petechiae
4
What must you exclude when diagnosing acute pharyngitis
GABHS, because it can lead to glomerulonephritis or RF
5
How do you treat acute pharyngitis
Supportive! and reassess in 5-7 days
6
What is the Centor criteria for diagnosing GABHS tonsillopharyngitis
Tonsillar exudate
Fever >38
No cough
tender anterior nodes
7
What is the center diagnostic criteria
0-2 Sx: probably not GABHS
3+ Sx: probably GABHS
Tx: 0-1, dont test
2-3, test to assess for GABHS
4, dont test, treat empirically
8
What do you do with RADT results
If +, patient has GABHS
If -, need to do a culture to actually rule out
9
What are complications of GABHS
Rheumatic fever
glomerulonephritis
scarlet fever
peritonsillar abscess
OM
10
How do you treat GABHS
1st: Penicillin V x 10 days
(or Amoxicillin x 10 days)
If allergic to penicillin, Macrolides (Erythromycin)
11
What is the criteria for a tonsillectomy
7 episodes in the last year
5 episodes in the last 2 years
3 episodes in the last 3 years
12
What is an "episode" for tonsillectomy criteria
ST and fever >100.9, Tonsillar exudate , anterior cervical adenopathy, culture confirmed
--All with correct Abx therapy
13
What causes peritonsillar abscesses
They are polymicrobial, but mostly GABHS inside
14
What are symptoms of peritonsillar abscess
Severe ST
hot potato voice
drooling
ipsilateral ear pain
15
What will you see on peritonsillar abscess PE
uvula deviation of midline
soft palate bulging
swollen tonsils
cervical LAD
16
How do you diagnose peritonsillar abscess
Clinical Dx
can get CBC, culture, or electrolytes
Can get CT if concerned about info spreading
17
How do you treat peritonsillar abscess
Supportive care
Monitor airway obstruction
(may need Needle aspiration/I&D
Abx)
18
What abx can you give for peritonsillar abscess
IV ampicillin sulbactam/ clindamycin
PO Augmentin/clindamycin x 14 days
--If patient has high rate of MRSA, Vanco
19
What causes acute laryngitis
mostly VIRAL (rhinovirus, influenza)
rarely bacterial (if so, strep, Moraxella, H. influenza)
Non-infectious (vocal abuse, GERD, trauma, toxins)
20
What are symptoms of acute laryngitis
Hoarseness
URI Sx (rhinorrhea, congestion, cough, ST)
21
What is the treatment for acute laryngitis
humidification
voice rest (no whispering)
smoking cessation
22
How long until acute laryngitis resolves
1-3 weeks
23
What are RF for epiglottis
incomplete/non-vaccination
immunodeficiency
24
What causes epiglottis
**H. Influenza/S. Aureus
streptococcus
(viral or bacterial)
25
What are symptoms of epiglottis
Drooling, Dysphagia, Distress
Tripod position
fever, stridor, odynophagia out of proportion to PE
26
When should you NOT examine the epiglottis
If the patient is anxious, you don't want to obstruct the airway!
27
What does an epiglottitis PE look like
usually normal
28
What diagnostics should you get for epiglottitis
Labs (once airway secured)
Imaging (thumb's sign)
direct laryngoscopy
29
How do you treat epiglottitis
emergently protect the airway
IV abx (3rd generation cephalosporin/vanco) +/- dexamethasone
30
