Throat Flashcards by Carson Church

Croup/LTB

A viral infection of the sub-glottic area leading to a barking cough

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Croup occurs most often in:

Children younger than 5

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Most common cause of croup:

Viral infection
-MC in fall through winter
-MC in boys than girls

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Croup typically occurs in:

A toddler that develops seal-like barking cough after several days of cold symptoms
-No fever or drooling

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Croup iffers from epiglottitis by:

-Croup: No fever/drooling, history of recent cold symptoms; sound worse, slow onset
-Epiglottitis: Fever/drooling (emergency), abrupt, occurs in slightly older patient; looks sicker

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Epiglottitis can lead to sudden ______

Asphyxia, go to the ER

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Think of Epiglottitis if:

-Patient cannot breathe unless sitting up
-Symptoms appear to be worsening
-Child can’t swallow saliva or drools
-Adult cannot swallow

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Treatment of Croup/LTB

-Office: Adjust, thoracic percussion
-Home care: Mist therapy, cold air therapy (20 mins)

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Further care of Croup/LTB

Humidify air, hydrate, Vitamin C + Echinacea, thoracic percussion

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Treatment of severe croup

Epinephrine (to open airways), oxygen

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Treatment of epiglottitis

-Don’t adjust: can cause sudden asphyxia
-ER referral

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Epiglottis triad

Dysphagia, Drooling, Distress

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Laryngitis

Inflammation and/or mass in the laryngeal part of the airway, leading to hoarseness, altered voice sounds and loss of voice

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Laryngitis: Chief symptoms

Hoarseness, loss of normal voice

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Laryngitis: Epidemiology & Risk Factors

-Acute laryngitis: Common in winter months, family history, patients who sing or talk for a living
-Chronic, persistent laryngitis: Smokers & people with allergies

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Acute laryngitis is caused by:

-Viral upper respiratory infectoin
-Overuse of talking

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Chronic laryngitis is caused by:

-Chronic overuse of voice
-Benign vocal cord nodule or cyst
-Laryngeal cancer

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Laryngitis: Contributing factors

Dry air, breathing in smoke/dust/gas, allergies, use of corticosteroid inhalers

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Main differential diagnoses of Laryngitis

-Over-use of the voice
-Viral upper respiratory infection
-Allergic reaction
-Acute exposure to dry/noxious air
-Benign lesions
-Malignant lesions

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Chronic Laryngitis: Causes

Smoking, occupational exposure, chronic over use of voice
-Less common: Cancer of larynx or lung

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Treatment of acute laryngitis

-Adjust subluxations
-Treat trigger points

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Laryngitis: Patient Self-Care

-Resting voice (even whispering)
-Hydrate and humidify air
-Vitamin C: 200-500mg
-Echinacea and zinc
-Throat lozenges or cough drops
-Honey: <1 yoa

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Treatment of Laryngeal Cysts, Nodules & Cancer

Surgical excision, chemo/radiation therapy (cancer), chiro care, removal of larynx

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Pharyngitis

Acute inflammation of the mucosa of the pharynx

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Sore throat is most common in:

School-aged kids

Infecious causes of sore throat

-Viruses (70% of cases) -Other conditions: SLE, canker sores (rare)

Miscellaneous causes of sore throat

Burns, cancer, leukemia, irradiation, chemotherapy, polyps

Most common cause of sore throat to rule out is:

Group A Beta-Hemolytic Streptococcus (GABHS)

Strep throat requires antibiotic treatment due to risk of a serious complication called:

Rheumatic fever

Viral sore throat

Usually not severe or prolonged -Usually cold symptoms are present

In young adults with viral sore throat consider:

Infectious mononucleosis

Sore throat from Post nasal drip

Irritation of the nasal mucosa can lead to increased mucus secretion

Causes of post nasal drip

Colds, sinusitis, allergies

Treatment of postnasal drip

1 teaspoon of liquid antacid at bedtime

Manifestations of Sore Throat

-Viral upper respiratory infection -GABHS pharyngitis (sore throat): Absence of cold symptoms

GABHS/Strep throat includes

-Fever up to 105 degrees F -Lymphdenopathy, especially tonsilar node -Red and swollen pharynx and tonsils -White tonilar exudates* -Pain on swallowing: without cold symptoms

Scarlet fever is caused by:

GABHS infection

Symptoms of Scarlet Fever

-Characteristic rash w/ paleness around mouth circumoral pallor -Red bumpy tongue, fever, swollen lymph nodes, headaches

GABHS Pharyngitis is most common in

Patients aged 6-12 yoa

GABHS Pharyngitis can lead to

Acute rheumatic fever and acute glomerulonephritis (But usually self-resolves)

Diagnosis of GABHS

Rapid Step Test Throat culture

Treatment of sore throat

OTC, analgesics, warm saline gargle, antibiotics

Rheumatic fever: Highest risk

Kids 5-15 yoa -Can cause permenent damage to the heart

Rheumatic Fever: Symptoms

-1-4 weeks after strep throat -Migrating polyarthritis & carditis (

Rheumatic fever can be prevented if antibiotic therapy is initiated within:

9-12 days of onset of strep infection

Rheumatic Fever Complications

Carditis: Heart Valves (1st) -Migratory Polyarthritis (2nd MC) -Chorea: Less Common

Rheumatic Fever: Treatment

Antibiotics (Penicillin) -Monitor hear function

Follow-up Care: Rheumatic Fever

Chiro care, prebiotics

Diptheria

Acute contagious disease

Diptheria is characterized by a ___ that:

Extotoxin; 1. Forms fibrinous pseudomembrane 2. Causes myocardial damage 3. Causes neural tissue damage

Diptheria is caused by:

Corynebacterium diphtheriae

Progression of Diptheriae

Fatigue Dysphagia Signs of toxemia Prostration -Complications: Myocarditis and toxic neuritis (CNs then motor weakeness)

Treatment of Diptheriae

-Diptheria antitoxin, antibiotics, best rest, isolate patient until cultures are negative

Prevention: Diptheriae

DPT VAccine -Shick Test

Pertussis

An acute, highly contagious bacterial disease characterized by a paroxysmal or spasmodic cough that usually ends in prolonged, high-pitched, crowing

Pertussis is caused by:

Bordatella pertussis -Transmitted by respiratory droplets

Patients with pertussis are not usually infectious/contagious after:

3rd week of paroxysmal phase

50% of pertussis cases are in:

Children less than 2 yoa (More common in developing countries)

Incubation period of pertussis

7-17 days

Manifestations of Pertussis

-Low Grade Fever -Symptoms usually last 6 weeks

Stages of Pertussis

1. Catarrhal (cold symptoms) 2. Paroxysmal (coughing jags) 3. Covalescent (healing)

Catarrhal Stage (Pertussis)

-Often looks like a bad chest cold or bronchitis -Fever is rare

Paroxysmal Stage

-After 10-14 days -Coughing jabs -Vomitting is common (mucus is emetic)

Convalescent Stage

-Begins about 4 weeks after onset of illness -Gradual decrease in frequency -Patient looks/feels better

Diagnosis of pertussis

-Looks like cold but doesnt go away -Child <2: Coughing jags, inspiratory whoop, vomitting, abscence of fever -70% lymphocytes

Pertussis: Prognosis/Complications

-Pertussis is serious in kids <2 yoa -Complications: Asphyxia, Pneumonia, Cerebral Hemorrhage, Otitis media

Treatment of Pertussis

Avoid cough triggers, bed rest/fluids -Experctorants and cough suppressants not helpful & should be avoided

Prophylaxis: Prevention

-DPT vaccine -Quarantine Early -Exposted people should get a booster shot

Throat Flashcards

(68 cards)