Podcast
Questions and Answers
How is group A strep pharyngitis typically transmitted?
How is group A strep pharyngitis typically transmitted?
- Through contaminated food and water
- Through airborne transmission
- Through vector-borne transmission
- Through direct person-to-person transmission (correct)
What is the incubation period of group A strep pharyngitis?
What is the incubation period of group A strep pharyngitis?
- 7 to 10 days
- 10 to 14 days
- 5 to 7 days
- 2 to 5 days (correct)
What is the gold standard diagnostic test for group A strep pharyngitis?
What is the gold standard diagnostic test for group A strep pharyngitis?
- Blood culture
- Rapid antigen detection test (RADT)
- Complete Blood Count (CBC)
- Throat culture (correct)
What is the primary goal of treating group A strep pharyngitis with antibiotics?
What is the primary goal of treating group A strep pharyngitis with antibiotics?
Why is intramuscular penicillin a treatment option for group A strep pharyngitis?
Why is intramuscular penicillin a treatment option for group A strep pharyngitis?
What is a potential complication of untreated group A strep pharyngitis?
What is a potential complication of untreated group A strep pharyngitis?
What is the purpose of antibiotic treatment in group A strep pharyngitis?
What is the purpose of antibiotic treatment in group A strep pharyngitis?
Why may azithromycin and clarithromycin not be the first-line antibiotics for group A strep pharyngitis?
Why may azithromycin and clarithromycin not be the first-line antibiotics for group A strep pharyngitis?
What is the primary reason for follow-up after diagnosing and treating pharyngitis?
What is the primary reason for follow-up after diagnosing and treating pharyngitis?
What is a potential complication of pharyngitis?
What is a potential complication of pharyngitis?
Why is it essential to educate patients with pharyngitis about antibiotic use?
Why is it essential to educate patients with pharyngitis about antibiotic use?
What is recommended to prevent the spread of pharyngitis to others in the home?
What is recommended to prevent the spread of pharyngitis to others in the home?
What is a recommended symptomatic treatment for pharyngitis?
What is a recommended symptomatic treatment for pharyngitis?
Why is it crucial to educate parents about aspirin use in young children?
Why is it crucial to educate parents about aspirin use in young children?
What is the typical duration of recovery from pharyngitis?
What is the typical duration of recovery from pharyngitis?
What is the primary cause of sinusitis?
What is the primary cause of sinusitis?
What is a potential complication of bacterial pharyngitis?
What is a potential complication of bacterial pharyngitis?
What should patients with a history of anaphylaxis to penicillin use as an alternative?
What should patients with a history of anaphylaxis to penicillin use as an alternative?
Why should steroids be avoided in patients with pharyngitis?
Why should steroids be avoided in patients with pharyngitis?
What is an important aspect of patient education for those diagnosed with group A streptococcus infection?
What is an important aspect of patient education for those diagnosed with group A streptococcus infection?
What is a differential diagnosis of pharyngitis?
What is a differential diagnosis of pharyngitis?
Why should patients with viral pharyngitis avoid using antibiotics?
Why should patients with viral pharyngitis avoid using antibiotics?
What is a recommended symptom management approach for patients with pharyngitis?
What is a recommended symptom management approach for patients with pharyngitis?
Why should patients with infectious mononucleosis avoid contact sports?
Why should patients with infectious mononucleosis avoid contact sports?
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Study Notes
Transmission and Incubation Period
- Group A strep pharyngitis is primarily spread through direct person-to-person transmission via respiratory droplets, contact with secretions, or saliva and nasal secretions from an infected person.
- Incubation period is approximately 2-5 days.
Diagnosis
- History and clinical examination can diagnose viral pharyngitis when clear viral symptoms are present.
- Rapid antigen detection test (RADT) or throat culture is required to confirm group A strep pharyngitis.
- RADTs have high specificity for group A strep, but varying sensitivities compared to throat culture.
- Throat culture is the gold standard diagnostic test.
Treatment
- Goals: symptom reduction, prevention of complications (suppurative and nonsuppurative), and prevention of transmission.
- Antibiotics (penicillin V or amoxicillin) shorten symptom duration by 16-24 hours and prevent rheumatic fever.
- Cephalosporins, macrolides, and clindamycin can also be used.
- Resistance may develop during treatment with azithromycin and clarithromycin.
Enhancing Healthcare Team Outcomes
- Follow-up is required to monitor patient progress and provide education on antibiotic use, hand hygiene, and personal hygiene.
- Patients should be told not to use antibiotics empirically as the cause is often viral.
- Immunization against the flu virus and diphtheria is recommended.
Outcomes
- Most pharyngitis cases recover spontaneously within 7-10 days.
- Failures may occur due to antibiotic resistance, lack of patient compliance, or if the cause is bacterial and antibiotics were not prescribed.
- Complications occur in less than 1% of patients, including otitis media, pneumonia, nephritis, and meningitis.
Sinusitis
- Sinusitis is swelling of the sinuses, usually caused by an infection, and typically clears up on its own within 4 weeks.
- Medicines can help if it's taking a long time to go away.
- Azithromycin or clindamycin can be used in patients with a history of anaphylaxis to penicillin.
Differential Diagnosis
- Airway obstruction from any cause
- Allergic rhinitis
- Cancer of the head and neck
- Gastroesophageal reflux disease
- Peritonsillar abscess
- Diphtheria
- Epiglottitis
- Herpes simplex virus
- Mononucleosis
Complications
- Epiglottitis
- Otitis media
- Mastoiditis
- Sinusitis
- Acute rheumatic fever
- Post-streptococcal glomerulonephritis
- Toxic shock syndrome
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