Pharyngitis

Question 1

primary concern of pharyngitis

Answer 1

to exclude more serious conditions including: peritonsillar abscess, epiglottitis, and retropharygneal abscess

ALWAYS CONSIDER AIRWAY OBSTRUCTION

Question 2

what causes brown pee in pharyngitis

Answer 2

GAS causing glomerulonephritis

Question 3

what causes rheumuatic fever from GAS

Answer 3

GAS releases protein fragments similar to myocardial antigens

Question 4

pharyngitis history overview…

Answer 4

stridor, drooling, trouble breathing, tenting, prolonged cap refill, dysphagia, odynophagia, uri symptoms, fever

Question 5

most common in what ages during what season

Answer 5

4-7 early spring

Question 6

sudden onset pharyngitis makes what more likely the cause

Answer 6

GAS

Question 7

pharyngitis with cough, rhinorrhea, or conjunctivitis makes what most likely the cause

Answer 7

viral

Question 8

peaks during ages… and what seasons

Answer 8

4-7 during mid winter/early spring

Question 9

primary concern with this

Answer 9

more serious conditions like peritonsillar abscess, epiglottitis, and retropharyngeal abscess

AND potential for airway obstruction

Question 10

adenovirus causes

Answer 10

conjuncitivitis

Question 11

coxscackie virus causes

Answer 11

ulcers and vesciles in hands feet and mouth

Question 12

CMV

Answer 12

cytomegalovirus is EBV but in older ppl

Question 13

herpes

Answer 13

oral vessicles in young children

Question 14

HIV

Answer 14

aphtous ulcers, adenopathy, myalgias, exudates (rare)

Question 15

GAS has what onset

Answer 15

sudden

Question 16

GAS presents with

Answer 16

headache, emesis, rheumatic fever, acute glomerulonephirits

Question 17

scarlet fever

Answer 17

GAS with rash

Question 18

other bacteria other than GAS that can cause pharyngitis

Answer 18

myocplasma and chalmydia pneumoniae, diphtheria, neiserria gonnorhea

Question 19

mycoplasma and chalrmydia pneunomie causes what

Answer 19

pnaryngtitis that can precede pneumonia by 1-3 weeks (pharyngitis before you get pneumonia from these organisms)

Question 20

what is a red flag that indicated diphtheria as the cause of pharyngitis

Answer 20

not vaccinated

foul smelling pseudomembrane

Question 21

neiserria gonorrhea can have what type of infection

Answer 21

systemic causing GU symptoms like burning when you pee

Question 22

how do you diagnose neissera gonorrhea pharyngitis

Answer 22

gonoccoal throat culture

Question 23

EBV symptoms

Answer 23

fatigue, upper abd pain, prominent exudates, posterior cervical lymphadenopathy, hepatosplenomegaly, rash?, rash with amox

Question 24

on labs what do you see with EBV

Answer 24

atypical lymphocytes and lymphocytosis

Question 25

what testing do you do for EBV (gold standard)

Answer 25

EBV specific antigen test = GOLD STANDARD

Question 26

Monospot test for EBV

Answer 26

not recommended, low sensitivity/specificity, it is easy and fast positive test will lower likely hood of GAS

Question 27

pharnygitis history looks at

Answer 27

airway issues hydration/oral intake illness exposure dysphagia/odynophagia URI symptoms fever centor criteria immune status and vaccine history

Question 28

pharyngitis physical exam- temp of over 100.4 indicated what

Answer 28

bacterial pathology

Question 29

paletal petichiae and tonsillar exudates indicated what

Answer 29

GAS or EBV

Question 30

oropharngyeal vessicles indicates

Answer 30

coxsackie virus or HSV

Question 31

scarlet rash is indicative of

Answer 31

GAS

Question 32

nonspecific maculopapular rash is indicative of

Answer 32

viral origin

Question 33

rash after exposure to amox is indicative of

Answer 33

EBV

Question 34

hepatosplenomegaly is indicative of

Answer 34

EBV

Question 35

to evaluate for pharyngitis you can do what 2 tests and which is prefered and why

Answer 35

Throat culture (gold standard bc of specificity) Rapid antigen testing for strep (preferred in ED)

Question 36

if rapid antigen testing for strep is negative do you still need a throat culture

Answer 36

yes

Question 37

treating up to how many days after onset of symptoms will prevent rheumatic fever

Answer 37

9 days

Question 38

do abx cure pharyngitis

Answer 38

no just shortens course and prevents rheumatic fever

Question 39

do abx for pharyngitis prevent glomerulonephritis

Answer 39

no

Question 40

when can steroids be used in the case of pharyngitis

Answer 40

airway compromise or symptomatic relief

Question 41

how long do you give penicillin or cephalosporins for GAS

Answer 41

10 days

Question 42

what does penicillin do to cells

Answer 42

inhibits cell wall synthesis

Question 43

complications of pharyngitis

Answer 43

rheumatic fever, glomerulonephritis, retropharyngeal abscee, peritonsillar abscess