week 10 Flashcards
(42 cards)
pharengitis
inflammation of the throat mucousa
GABHS
most comomon cause of acute threp throat that is bacteria (35%) ages 5-11 years
viral vs bacteria pharengitis symtptoms
same except viral includes : diarrea, rhinitis, stridor, rash, cough etc.
look of bacterial vs viral pharyngitis
bacterial gahs: swollen uvula, swollen tonsils, petichia, gray furry tongue
viral: red twollen tonsils, throat redness,
CENTOR criteria to determine what?
GAHS only for ADULTS, but there is a modified version for kids
looking at
-fever
- swollen lymphs,
-tonsillar exudate,
-absence of cough
RADT criteria
not under 3
need culture confirmation
negative should be cultured
ASO titer
rises one week after infection, peaks 3-5 weeks
- for determining phumatic fever and acute glomularnephritis
-detects GAHS in the system from a previous infection
treatment for strep throat
Amoxacillin or penicillin
Amox: more easily taken by the kids, 50mg/kg/day
Penicillin: low cost, 250mg 2-3 times per day for 10 days
alternative therpies for pen. allergy
- cephalexin (NOT for kids with immediate-type hypersensitivity to penicillin)
- clindamycin
-azithromycin
-clarithromycin
school rule for antibiotics
at least 12-24 hours of abx and no fever
retropharengeal absess and peritonsillar absess
retropharengeal absess: <6 years of age
pertonsilar absess: peaks ar age 13.5 years
suppurative complications og GAHS VS nonsuppurative complication
suppurative: cervical adenitis, mastoiditis, AOM, rhinosinusitis, absesses
nonsuppurative: rheumatic fever, post-streptococcal reactive arthritis
actute glomularnephritis
T and A removal indication
infection:
-7 infections in last year,
-5 in the last 2 years,
-or three or more per year in the past 3 years
-Infections have to meet GAHS test, have fever and lymph involvment
noninfection:
-recurrent tonsilitis
-sleep apnea
-peritoneal abscess
-periodic fever with aphthous -ulcers
-adenopathy
Adenoid removal:
- severe nasal obstruction for > 1 year
- hyponasal speech
- chronic mouth breathing
Croup is also known as
laryngotracheobronchitis
croup symtoms
- barky cough
-inspirtorytridor
-resp distress
cause of croup
human para influenze virus
peak age croup
5 mo-5 years
tx for croup
typically self limiting but sometimes require supportive tx
physical exam croup findings
- irritability
- audible inspiratory stridor
- brassy barky cough
- restrictions
- prolonged inspiration
xray findings croup
- steeple sign (subglottal narrowing)
diff diagnosis for croup
- acute epiglotits
- bacterial tracheitis
- forign body aspiration
- abscesses
- extrinsic compression
- angioedema
- infectious monoculcosis
- psychogenic stridor
how to rule out absess? when trying to detemine croup or absess?
CT scan
mild, moderate and severe croup
mild: no retractions, no stridor at rest
moderate, retractions and stridor at rest
severe: respirtory distress
TX croup
single dose .15 mg/kg oral dexamethasone
OTHERS
nebulized budesonide
IM dexamethasone
oral prednisolone
