Oral Cavity and Throat Disease Flashcards
(70 cards)
What is the most common cause of bacterial sore throat?
Streptococcus pyogenes (also known as Group A streptococcus, or Group A Beta Haemolytic Strep)
Explain the complications and the risks of not treating strep throat?
Earlier complications:
Spread to surrounding structures such as meningitis, otitis media, pneumonia
Later complications:
Rheumatic fever
Glomerulonephritis
It is thought that if the strep throat infection is untreated or inadequately treated by antibiotics, the bacteria remain in the tonsils and promote a persistent immune response from the body.
Describe symptoms and signs of rheumatic fever?
Symptoms usually appear 2 to 4 weeks after you have had a bacterial throat infection.
They include:
a high temperature of 38C or above (fever)
redness, pain and swelling of your joints (arthritis) – usually ankles, knees, wrists or elbows
pain in your chest, breathlessness and a fast heart rate
jerky, uncontrollable movements in your hands, feet and face
tiny bumps under your skin
pale-red patches on your arms and tummy
Treatment of strep throat?
Penicillin
Common pathogen of hand foot and mouth disease?
coxsackievirus (from enteroviruses group)
Signs and symptoms of hand foot and mouth disease?
a sore throat a high temperature, above 38C not wanting to eat mouth ulcers Ulcers on hand and feet
Describe apthous ulceration?
Non viral, self limiting Recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos Confined to mouth Absence of systemic disease Often related to stress Shouldn't last more than 3 weeks
If an ulcer lasts more than ___ weeks it needs investigated
3
If sore throat and lethargy persist into the second week, especially if the person is 15-25years of age __________________
infectious mononucleosis/ glandular fever (caused by Ebstein Barr Virus )should be suspected.
Vast majority of sore throats are caused by _________
viral infection AND THEREFORE DO NOT NEED ANTIBIOTICS
Strep pyogenes is _______
gram positive (PURPLE) beta haemolytic cocci in chains
What bacteria causes diphtheria?
Corynebacterium diphtheriae
Severe sore throat with a grey white membrane across the pharynx?
Diptheria
What are the serious complications of diphtheria?
Potent exotoxin is cardiotoxic and neurotoxic. It can lead to difficulty breathing, heart failure, paralysis, and even death.
Signs of EBV?
Gross tonsillar enlargement with membranous exudate Marked cervical lymphadenopathy Palatal petechial haemorrhages Generalised lymphadenopathy Hepatosplenomegaly
Investigations for EBV?
Atypical lymphocytes in peripheral blood
+ve Monospot or Paul-Bunnell test
Low CRP (<100)
Don’t give amoxicillin in _____
throat infections > tonsillitis or EBV
What is tonsillitis?
Inflammation of the tonsils with majority due to viral infection
Common pathogens in tonsillitis?
Majority of acute cases are caused by EBV, rhinovirus, influenza, parainfluenza, enterovirus and adenovirus
Chronic tonsillar disease is more likely to be bacterial or viral? What pathogens?
Bacterial
Strep pyogenes, H influenza, S aureus and strep pneumonia
Viral presentation of tonsillitis vs Bacterial presentation?
VIRAL: Malaise, sore throat, temperature, possible lymphadenopathy, able to undertake normal activity, 3-4 days, cough
BACTERIAL: systemic upset, fever, odynophagia, halitosis, lymphadenopathy, unable to work, lasts about a week, absence of cough, presence of exudates
What is the centor criteria?
History of fever
Tonsillar exudates
Tender anterior cervical adenopathy
Absence of cough
Treatment of tonsillitis?
Supportive- eat, drink, rest, paracetamol, NSAIDs
If need antibiotic penicillin for 10 days, clarithromycin if allergic
Hospital admission- IV fluids, IV antibiotics, steroids
Strict guidelines for tonsillectomy?
Sore throats must be due to tonsillitis
Episodes must be disabling
7 or more well documented, clinically significant, adequately treated in the preceding years or 5 in 2 yrs or 3 in 3 yrs
NOTE SURGERY IS V SORE AND RISK OF COMPLICATIONS
