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ENT > Throat conditions > Flashcards

Throat conditions Flashcards

1
Q

What is the most common bacterial cause of a sore throat?

A

Group a beta haemolytic strep (strep pyogenes)

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2
Q

List all the possible causes of a bacterial tonsillitis

A

Strep pyogenes
Haemophilus influenzae
Staph aureus
Strep pneumonia

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3
Q

What are the four criteria that indicate a bacterial tonsillitis over a viral tonsillitis?

A
  1. Fever
  2. Tonsillar exudate
  3. Tender anterior cervical adenopathy
    4, Absence of cough
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4
Q

How many points should a patient have on the centor criteria if “they should receive an antibiotic if the symptoms progress”

A

2 - 3

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5
Q

How many points should a patient have on the centor criteria if you should start empirical antibiotic therapy?

A

4

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6
Q

What antibiotic therapy should you start for bacterial tonsillitis?

A

Penicilin

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7
Q

What antibiotic therapy should you start for bacterial tonsillitis in a penicillin allergic patient?

A

Clarithromycin

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8
Q

What antibiotic therapy should you start for bacterial tonsillitis if they are unable to swallow?

A

Benzyl penicillin IV

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9
Q

How many episodes of tonsillitis should a patient have in a year before surgery is performed?

A

7

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10
Q

What is the general criteria for receiving a tonsillectomy?

A

7 episodes in one year
5 episodes in each of two years
3 episodes each year for three years

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11
Q

What causes a peritonsillar abscess?

A

Production of pus from the bacteria between the muscle and the tonsil.

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12
Q

A patient who has had an extremely sore throat for the last 4 days presents with difficulty swallowing and difficulty opening and closing the mouth. On examination the uvula appears to be medially displaced.

A

Peri tonsillar abscess

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13
Q

What does waldeyers ring contain and where does it lie?

A

It surrounds the entrance to the aerodigestive tract. Includes palatine tonsils, lymphoid tissue in the tongue base and lingual tonsils.

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14
Q

A 4 year child presents with his mother. She says he snores very loudly and at times appears to stop breathing during the night,

A

Obstructive sleep apnea due to enlarged adenoids.

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15
Q

What is the treatment for obstructive sleep apnea in a child, due to enlarged tonsils?

A

Adenoidectomy

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16
Q

How do you treat a quinsy?

A

Aspiration o pus and antibiotic treatment

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17
Q

What organism causes glandular fever?

A

Epstein Barr virus

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18
Q

A 18 year old girl presents with extreme fatigue and a sore throat. On examination she has enlarged tonsils and cervical lympadenopathy.

A

Glandualr fever

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19
Q

A lady who has recently moved to the UK presents with an extremely painful throat and on examination you see a white membrane across the pharynx.

A

Diptheria

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20
Q

How do you treat a patient with diptheria?

A

Antitoxin
Supportive treatment
Penicillin or erythromycin

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21
Q

An asthmatic lady presents with white patches on her throat. One xamination these are visible as well as red, raw mucous membranes.

A

Canidida

22
Q

What is the treatment of oral thrush?

A

Nystatin

23
Q

What would you see in the peripheral blood of a patient with infectious mononucleosis?

A

Atypical mononuclear cells (activated CD8 + T lymphocytes)

24
Q

How do you confirm a diagnosis of infectious mononucleosis?

A

Paul Bunnel test. This detects heterophile antibodies (IgM) that causes clumping of red blood cells.

25
Q

What is the treatment for glandular fever?

A

Bed rest
Paracetamol
No sport (risk of splenic rupture)
Corticosteroids are sometimes indicated (if there is neurological involvement or marked haemolysis)

26
Q

What virus causes cold sores?

A

Herpes simplex virus 1

27
Q

What is the lab confirmation of HSV?

A

PCR

28
Q

What virus causes herpangina (ulcers on the soft palate)

A

Coxsakie virus

29
Q

What virus causes hand foot and mouth disease?

A

Coxsackie

30
Q

What is wegners granulomatosis?

A

An autoimmune disorder characterised by a small vessel vasculitis limited to the respirator tract and kidneys.

31
Q

In wegners granulomatosis ANCA positive or ANCA negative?

A

Positive

32
Q

What are laryngeal polyps and what causes them?

A

The are caused by a recative change in the laryngeal mucosa secondary to vocal abuse (such as singing) and smoking.

33
Q

A 28year old proffesional singer presents with hoarsness. What do you do?

A

Vocal polyp

Rest the voice

34
Q

What is a laryngeal contact ulcer?

A

A benign ulcer on the larynx that occurs in response to injury such as vocal abuse or GORD

35
Q

What types of HPV predispose you to getting a squamous papilloma?

A

6 and 11

36
Q

A 34 year old lady present with hoarsness. She also complain of heartburn.

A

Contact ulcer due to GORD

37
Q

What is a paraganglioma?

A

A tumour arising in clusters of neuroendocrine cells dispersed throughout the body

38
Q

Are paragangliomas found in the larynx cromaffin positive?

A

No

39
Q

Give an example of chromaffin positive paragangliomas?

A

Adrenal medulla tumours (phaechromocytoma)

40
Q

What does it mean if a paraganglioma is chromaffin positive?

A

It is formed from the sympathetic nervous system and can secrete catecholamines

41
Q

What condition are paragangliomas associated with?

A

MEN 2

42
Q

What kind of cancer can be caused by HPV infection?

A

Squamous cell carcinoma. Most often in the oropharynx

43
Q

Name the three main salivary glands

A

Parotid
Submandibular
Sublingual

44
Q

What is sialolithiasis?

A

Salivary gland stones

45
Q

What type of HPV infection predisposes you to getting a squamous cell carcinoma?

A

16

46
Q

A 72 year old women presents to you worried about a lump on thus side of her face, just above her upper molars, that seems to be getting bigger.

A

Pleomorphic adenoma of the parotid gland

47
Q

A 73 year old man presents with bilateral enlarged parotid glands. He smoked 20 a day.

A

Warthins tumour of the parotid

48
Q

Name two benign salivary gland tumours

A

Warthins tumour

Pleomorphic ademona

49
Q

In which salivary glands are you most likley to get a pathology?

A

Parotid

50
Q

A 55 year old women presents with enlargement of her parotid gland which is very painful. She has recently started to get difficulty chewing.

A

Adenoid cystic tumour (malignant)

ENT (13 decks)

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