ENT Infections Part 2

Question 1

HIV associated lesions and their microbial cause

Answer 1

1. thrush: candida
2. leukoplakia: EBV
3. kaposi sarcome: HHV-8/KSHV

Question 2

microbial cause?

Answer 2

HHV6

Question 3

aphthous ulcer is found on which type of tissue?

Answer 3

non-keratinized mucosa (Buccal, labial mucousa, not gingiva or palate)

Question 4

tx: aphthous ulcer

Answer 4

1. topical & topical steroid
2. thalidomide (recurrent cases - HIV)

Question 5

define noma or cancrum oris

Answer 5

non-infectious oro-facial gangrenous stomatitis

involves bone

Question 6

acute necrotizing gingivitis may precipitate which condition?

Answer 6

noma or cancrum oris

Question 7

2 MC microbes that cause noma/cancrum oris

Answer 7

1. fusobacterium
2. prevotella intermedia

Question 8

noma/cancrum oris tx

Answer 8

1. nutritional therapy
2. abx: penicillin
3. surgery

Question 9

herpangina is caused by which virus?

Answer 9

Enterovirus (coxsackie or echo)

Question 10

season for herpangia?

Answer 10

summertime

Question 11

Coxsackie A causes which condition?

Answer 11

hand foot & moutht

Question 12

Herpetic stomatitis (HSV-1) 3 clinical forms

Answer 12

1. recurrent small blisters (MC)
2. oral infection (primary herpetic stomatitis)
3. smsll ulcers (palatal mucosa; rare)

Question 13

pharyngitis sx if infected w/HSV or enterovirus

Answer 13

vesicles or ulcers
(other sx: fever, sore throat, odynophagia, lymphadenopathy)

Question 14

MC microbes that cause pharyngitis (8)

Answer 14

1. S. pyogenes
2. adeno
3. rhino
4. entero
5. flu
6. RSV
7. coxsackie
8. moraxella catarrhalis

Question 15

mild pharyngeal symptoms w/rhinorrhea suggests a _______ etiology

Answer 15

viral

runny nose is NOT seen w/bacterial

Question 16

exudative pharyngitis or pharyngitis + rash suggests which etiology?

Answer 16

1. EBV
2. HIV

Question 17

diphtheria is a normal flora, how do people get infected?

Answer 17

toxin w/phage infects bacteria

Question 18

if you suspect which microbes fro pharyngitris you need to request special culture media?

Answer 18

1. neisseria
2. diphtheria

seriologic for virus

Question 19

If you hear stridor (especially in children), what is the next step?

Answer 19

r/o epiglottitis or FB w/xray

Question 20

Venous complications of pharyngitis

Answer 20

jugular vein thrombosis

Question 21

incidence of epiglottitis

Answer 21

1. winter
2. spring

Question 22

epiglottitis is usually of _______ etiology

Answer 22

bacterial

Question 23

epiglottitis sx (5)

Answer 23

1. muffled cough
2. hoarseness
3. cherry red epiglottis
4. retractions
5. drooling

(fever & sore throat)

Question 24

ddx: epiglottitis (4)

Answer 24

1. croup
2. FB
3. angioedema
4. abscess (retropharyngeal, peritonsillar)

Question 25

predominant immune cell in epiglottitis

Answer 25

PMN

Question 26

MC cause of epiglottitis in unvaccinated children

Answer 26

H. influenza B

Question 27

3 MC bacterial microbes that cause epiglottitis

Answer 27

1. S. aureus 1. S. pneumoniae 1. S. pyogenes

Question 28

MC cause of laryngitis

Answer 28

viral

Question 29

laryngitis sx (3)

Answer 29

1. hoarseness 1. aphonia 1. rhinitis or pharyngitis | (exudate in diph, GAS, EBV)

Question 30

if laryngitits (hoarsness) persists beyond 2 weeks, what is the next step?

Answer 30

laryngoscopy

Question 31

Non-infectious causes of laryngitis

Answer 31

1. GERD 1. tumor 1. overuse 1. chemical irritant | you won't see signs of infection

Question 32

What condition is caused by a subglottic inflammation and edema?

Answer 32

croup

Question 33

MC location of croup

Answer 33

upper respiratory tract

Question 34

MC age group affected by croup

Answer 34

6 mo - 6 yrs (MC 2 yrs)

Question 35

Croup is MC caused by _________ etiology

Answer 35

viral

Question 36

Croup sx

Answer 36

1. brassy cough 1. hoarsness 1. stridor 1. rhinorrhea **(rhinorrhea is first sx)**

Question 37

Croup is almost always caused by which virus?

Answer 37

parainfluenza (flu & RSV also)

Question 38

Croup on physical exam (4)

Answer 38

1. stridor 1. ronchi 1. crepitations/wheezing 1. diminished breath sounds