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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

How can you PREVENT epiglottitis

immunization!