Acute Epiglottitis
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Questions and Answers

What is a key consideration in managing acute epiglottitis?

  • Maintaining a patent airway to prevent compromise (correct)
  • Using a tongue depressor to examine the oropharynx
  • Prescribing antiviral medications to reduce symptoms
  • Administering antibiotic therapy as soon as possible

What is a characteristic feature of peritonsillar abscess?

  • Tender cervical lymphadenopathy
  • Severe cough and chest pain
  • Unilateral sore throat and trismus (correct)
  • Bilateral tonsillar involvement

What is a common causative organism of peritonsillar abscess?

  • Haemophilus influenzae (correct)
  • Escherichia coli
  • Candida albicans
  • Pseudomonas aeruginosa

What is a characteristic symptom of acute epiglottitis?

<p>Muffled voice and inspiratory stridor (D)</p> Signup and view all the answers

What is a key aspect of diagnosing peritonsillar abscess?

<p>Making a clinical diagnosis based on presentation (D)</p> Signup and view all the answers

What is a common complication of acute epiglottitis?

<p>Airway obstruction (A)</p> Signup and view all the answers

What is the primary cause of bacterial infection in acute epiglottitis?

<p>Haemophilus influenzae (A)</p> Signup and view all the answers

What is the diagnostic sign on a lateral radiograph of the neck in acute epiglottitis?

<p>Thumb sign (D)</p> Signup and view all the answers

What is the age group that was most commonly affected by acute epiglottitis in the past?

<p>Children aged 2-6 (D)</p> Signup and view all the answers

What has decreased the incidence of acute epiglottitis?

<p>HiB vaccination in infants (D)</p> Signup and view all the answers

What is a complication of retropharyngeal abscess?

<p>All of the above (D)</p> Signup and view all the answers

What is a symptom of primary HIV infection?

<p>All of the above (D)</p> Signup and view all the answers

What is a non-infectious cause of pharyngeal pain?

<p>Cocaine smoking (D)</p> Signup and view all the answers

What is a type of cancer that can present with pharyngeal pain?

<p>Lymphoma (D)</p> Signup and view all the answers

What is the most likely diagnosis for a patient with a sore throat, fever, and medial displacement of the uvula, palatine tonsil, and anterior pillar?

<p>Peritonsillar abscess (A)</p> Signup and view all the answers

What is the peak incidence age for retropharyngeal abscess?

<p>3-5 year olds (D)</p> Signup and view all the answers

What is the best way to confirm a diagnosis of peritonsillar abscess?

<p>Culture of pus from abscess drainage (C)</p> Signup and view all the answers

What is the treatment for a retropharyngeal abscess?

<p>Antibiotic therapy, possible surgical consultation for needle aspiration or incision and drainage (C)</p> Signup and view all the answers

What is the temperature above which a fever is considered?

<p>38°C (100.4°F) (A)</p> Signup and view all the answers

What symptom is strongly suggestive of an infectious cause of pharyngitis?

<p>Fever (D)</p> Signup and view all the answers

Flashcards

Acute Epiglottitis Management

Ensure a clear airway to prevent breathing difficulties.

Peritonsillar Abscess Feature

Severe unilateral sore throat and difficulty opening the mouth.

Peritonsillar Abscess Cause

Often caused by Haemophilus influenzae bacteria.

Acute Epiglottitis Symptom

Soft, muffled voice and noisy breathing upon inhaling.

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Diagnosing Peritonsillar Abscess

Diagnosis based on clinical signs and symptoms.

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Acute Epiglottitis Complication

Breathing passage obstruction.

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Bacterial Cause of Acute Epiglottitis

Haemophilus influenzae is the most common bacterial culprit.

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Acute Epiglottitis X-Ray Sign

Swollen epiglottis looks like a thumb on an X-ray.

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Historical Acute Epiglottitis Age

Previously, children between 2 and 6 years old.

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Decrease in Acute Epiglottitis

Vaccination against Haemophilus influenzae type B (HiB).

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Retropharyngeal Abscess Complication

Can cause dangerous airway blockage or infection spread.

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Symptom of Primary HIV Infection

Can cause sore throat, fever, fatigue.

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Non-Infectious Pharyngeal Pain

Cocaine use can damage throat tissues, causing pain.

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Cancer Causing Pharyngeal Pain

Lymphoma may manifest with throat discomfort.

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Displaced Uvula Diagnosis

Peritonsillar abscess.

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Retropharyngeal Abscess Age

Typically affects children aged 3 to 5 years.

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Confirming Peritonsillar Abscess

Pus culture confirms bacterial infection.

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Retropharyngeal Abscess Treatment

Antibiotics and possible surgical drainage.

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Fever Temperature Threshold

A temperature above 38°C indicates fever.

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Infectious Pharyngitis Symptom

Highly indicative of an infectious cause.

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Study Notes

Airway Management

  • Airway management is crucial to prevent airway compromise
  • May require intubation
  • Requires antibiotic therapy

Acute Epiglottitis

  • Acute onset fever, severe sore throat, toxic appearance
  • The 4 Ds: dysphagia, drooling, dysphonia, and distress
  • Do not use a tongue depressor when examining the oropharynx as it can precipitate airway obstruction

Peritonsillar Abscess

  • Also known as quinsy
  • Most common deep infection of head and neck (30% of abscesses)
  • Most common in young adults (ages 20-40); increased risk in immunocompromised and diabetics
  • Begins as acute tonsillitis → cellulitis → abscess formation
  • Polymicrobial infection with common organisms including Group A streptococci, Staphylococcus aureus, and Haemophilus influenzae
  • Clinical presentation: severe unilateral sore throat, dysphagia, fever, and malaise
  • Diagnosis can be made clinically without labwork/imaging in patients with typical presentation
  • Oropharyngeal exam: erythematous enlarged tonsil and bulging soft palate on affected side, uvular deviation to contralateral side
  • May have severely tender cervical lymphadenopathy

Retropharyngeal Abscess

  • Retropharyngeal edema due to cellulitis and suppurative adenitis of lymph nodes in retropharyngeal space
  • Preceded by upper respiratory infection, pharyngitis, otitis media, or wound infection following penetrating injury to posterior pharynx
  • Peak incidence in 3-5 year olds
  • Observed as prevertebral soft-tissue thickening on lateral X-ray of neck
  • Treat as impending airway emergency
  • Requires antibiotic therapy, possible surgical consultation for needle aspiration or incision and drainage

Clinical Presentation of Retropharyngeal Abscess

  • Sore throat and dysphagia
  • Fever
  • Drooling
  • Dysphonia (muffled voice)
  • Neck stiffness; limited neck ROM (especially hyperextension)
  • Stridor
  • May see bulging of the posterior wall of oropharynx on clinical examination

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Description

A quiz on the clinical presentation and management of acute epiglottitis, a life-threatening condition that requires prompt recognition and treatment.

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