Oral Cavity

Question 1

What are the Initial S and S of Acute Pharyngitis?

Answer 1

Dryness and scratchiness
Throat Pain
Malaise and Headache
Slight Fever

Question 2

What are the later Sx of Acute Pharyngitis?

Answer 2

Dysphagia
Sore throat
Malaise
Fever 104F
Fetid Breath
Otalgia

Question 3

What is the Tx of Acute Pharyngitis?

Answer 3

Antimicrobials (culture pos only)
Warm throat Irrigation
Supportive care

Question 4

What are the most common Etiologies of Acute Pharyngitis?

Answer 4

B Hemolytic Strep Group A 
Strep Viridans
Pneumococci 
Staph
H influenzae
Viruses

Question 5

What is the Tx of Acute Tonsillitis?

Answer 5

Bed Rest, Fluids, Oral analgesics, gargles

ABTX: Penicillin

Question 6

What are the signs of Infectious Mononucleosis?

Answer 6

Acute infectious disease

Fever, malaise, somnolence, LN enlargement (Post Tri), Lymphocytosis

Question 7

What are the causes of Infectious Mono?

Answer 7

EBV or CMV

Question 8

What are the Sx of Mono?

Answer 8

Malaise
Macular Rash
Enlarged LN => Ulcerates
Fever, chills
Splenomegaly

Question 9

How is Mono Diagnosed?

Answer 9

CBC: Elev CBC w/ Neutrophils
Lymphocytic Leukocytosis
POS MONO SPOT
Heterophil Ab titer >1:60
Culture to rule out B-Hemolytic pharyngitis

Question 10

What is the Tx of Mono?

Answer 10

Syptomatic
Prednisone
Reduced Activity

Question 11

What are the Complication of Mono?

Answer 11

Ruptured Spleen
Guillian Barre Ascending Paralysis
CN Paralysis

Question 12

What are the Sx of a Peritonsillar Abcess?

Answer 12

Swelling interferes w/ articulation and speech
Tonsil may appear normal
Trismus

Question 13

What is trismus?

Answer 13

Spasm of jaw muscles making it difficult to open the mouth

Question 14

What is the Pathophys of Peritonsillar Abcess?

Answer 14

Supprative Infiltration in supratonsillar fossa
Edema of soft palate
Swelling to adj soft tissue

Question 15

What is the Most common bacterial cause of Peritonsillar Abcess?

Answer 15

Strep Pyogenes

Question 16

What is the Tx of Peritonsillar Abcess?

Answer 16

1) Surgical incision and drainage
Pus? Abcess
No Pus? Cellulitis
2) Abtx and Saline irrigation

Question 17

What are the traits of retropharyngeal Space?

Answer 17

Entire length of neck
Anterior: Pharynx and esophagus
Posterior: Alar layer of Deep fascia
Inferior: Superior Mediastinum
Retropharyngeal nodes

Question 18

What are the Sx of Retropharyngeal Abcess?

Answer 18

Torticollis 
Nuchal Rigidity
Airway Sx 
Symmetric 
Voice Change less common

Question 19

What is the Tx of RP Abcess?

Answer 19

Airway Mngt
Surgical incision and drainage
IV Hydration, ABTX, Steroids

Question 20

What are the indications of Tonsillectomy?

Answer 20

7 episodes in 1 yr
5/year for 2 yrs
3/yr for 3 yrs
Fever, LAD, Exudate, Pos for GABHS

Question 21

What are the principles of Surgical Tonsillectomy?

Answer 21

Guillotine
Tonsillotome
Becks snare
Dissection w/ snare
Electrodissection
Laser Dissection

Question 22

What are criteria for overnight obs after tonsillectomy?

Answer 22

Poor oral intake, Vomit, hemor
Age 45 mon away
Poor Soc Econ cond
Comorbidities
OSA or PTA
Abn coag values

Question 23

What are the post-op complications of Tonsillectomy?

Answer 23

Post-op bleeding
Sore throat, otalgia, uvula swelling
Resp compromise
Dehydration
Burns other trauma

Question 24

What are indications for Adenoidectomy?

Answer 24

Obstruction: Dysphagia, speech problems
OSA
infection

Question 25

What is pre-op eval of adenoid disease?

Answer 25

Triad: Hyponasality, snoring, mouth breathing
Rhinorrhea, noct cough, PND
Adenoid facies
Overbite, long face, crowded incisors