Throat MDT Flashcards
(44 cards)
Predisposing factors for:
Epiglottitis
Diabetes
Contact with group A-B-hemolytic Streptococci
Symptoms and physical exam:
Rapidly developing sore throat or odynophagia is out of proportion to minimal oropharyngeal findings
Laryngoscopy may demonstrate swollen, erythematous epiglottis
Epiglottitis
Labs/Studies:
Epiglottitis
Lateral plain radiography may demonstrate enlarged epiglottis (thumb sign)
Treatment for:
Epiglottitis
IV Antibiotics
- Ceftizoxime 2g x 8-12 hours
- Levofloxacin 750mg IV q 24 + Clindamycin 900mg IV q6-8 hours
IV Corticosteroid
-Dexamethasone
White lesion that cannot be removed by rubbing the mucosal surface
Hyperkeratosis usually in response to a physical or chemical irritant
Leukoplakia
Most common oral precancer
2-4% show dysplastic changes
Most common site is buccal mucosa
Leukoplakia
Leukoplakia lesions of the floor of the mouth, tongue, and vermilion border are most likely associated with:
Malignancy
Predisposing factors for:
Leukoplakia
Alcohol
Tabacco
Dentures that don’t fit
Symptoms and physical exam:
- White painless lesion that cannot be scraped or removed
- Small to several cm in diameter
- Usually superficial but may have submucosal depth upon palpation
- May have wrinkled “wet finger” appearance
- May have redness or dysplasia
Leukoplakia
Labs/studies:
Leukoplakia
Refer to biopsy to rule out dysplasia
Treatment for:
Leukoplakia
None
Remove irritants and educate patient
Measure and document for malignancy
Refer if redness or submucosal depth
Follow-up for:
Leukoplakia
Refer if malignancy pathology suspected
If not, re-evaluate annually
A collection of purulent material between the tonsillar capsule and the superior constrictor and palatopharyngeal muscles
Peritonsillar abscess
Predisposing factors for:
Peritonsillar abscess
Chronic tonsillitis
Multiple trials of oral antibiotics
Previous peritonsillar abscess
Symptoms and physical exam:
- Severe sore throat
- Odynophagia
- Muffled (hot potato) voice
- Trismus
- Inferior and medial displacement of infected tonsil
- Moist and translucent
- Palatal edema
- Tender cervical lymphadenopathy
- Drooling
- Dehydration
- Color ranging from nearly none to deep erythema
Peritonsillar abscess
Labs/studies:
Peritonsillar abscess
Ultrasound
Treatment for:
Peritonsillar Abscess
Ceftriaxone 2g IV QD & Metronidazole 500mg IV q6h
-PCN Allergy: Clindamycin 600mg IV q8h
MEDEVAC for I&D
If you had to I&D a peritonsillar abscess, how would you?
19-21 gauge needle
Medial to the molar
No deeper than 1 cm because the carotid artery is there
Accounts for 10% of office visits for primary care
50% of outpatient antibiotic use
Tonsillitis and pharyngitis
Main concern for pharyngitis/tonsillitis, as this could pose a threat for complications such as rheumatic fever and glomerular nephritis
Determining who has group A-B hemolytic streptococcal infection (GABHS)
More than what percentage of primary infections of HIV are associated with acute pharyngitis
70%
Fungal pharyngitis
Candida albicans
Symptoms and physical exam:
- Incubation period of 2-5 days a sudden onset of sore throat, painful swallowing, chills, fever, headache, nausea, and vomiting
- Erythema of the tonsils, tonsillar pillars and edematous uvula
CENTOR criteria:
1) Fever over 38 degrees C
2) Tender anterior cervical lymph nodes
3) Lack of cough
4) Pharyngotonsillar exudates
A-B-Hemolytic streptococcal (GABHS) infection Pharyngitis/Tonsillitis
Symptoms and physical exam:
Marked lymphadenopathy with shaggy white-purple exudates that often extends into the nasopharynx
Mononucleosis
