Clinical Medicine: Pharyngitis and Infectious Mononucleosis

Practice flashcards covering the anatomy, causes, diagnosis, and complications of acute and chronic pharyngitis, as well as infectious mononucleosis.

Acute Pharyngitis

Inflammation of the pharynx lasting less than $2$ weeks.

Chronic Pharyngitis

Inflammation of the pharynx lasting more than $2$ weeks.

GABHS

Group A beta-hemolytic streptococci, which is the most common bacterial cause of pharyngitis.

Acute Epiglottitis

A rare but potentially fatal bacterial infection, primarily caused by $Haemophilus\ influenzae$, involving inflammation of the epiglottis and adjacent tissues.

The 4 Ds

The clinical presentation signs for acute epiglottitis: Dysphagia (difficulty swallowing), Drooling, Dysphonia (muffled voice), and Distress (respiratory stridor or tripod position).

Thumb Sign

A diagnostic finding on a lateral radiograph of the neck representing a swollen epiglottis in cases of acute epiglottitis.

Peritonsillar Abscess

Also known as "quinsy," it is the most common deep infection of the head and neck, often resulting as a complication of tonsillitis.

Hot Potato Voice

A muffled dysphonia characteristic of patients with a peritonsillar abscess.

Trismus

Inability to open the mouth fully, which is present in $66\%$ of patients with peritonsillar abscess.

Retropharyngeal Abscess

An infection resulting in prevertebral soft-tissue thickening on a lateral X-ray, with peak incidence in children aged $3$ to $5$ years.

Scarlet Fever

A condition that may evolve from GABHS pharyngitis, characterized by a scarlatiniform (sandpaper) rash and strawberry tongue.

Strawberry Tongue

A very red, inflamed tongue with prominent papillae found in cases of scarlet fever.

Palatal Petechiae

Small red spots on the soft or hard palate that can be seen in various types of pharyngitis, including strep throat and mononucleosis.

Acute Rheumatic Fever (ARF)

A rare non-suppurative complication of GABHS pharyngitis that can develop $1$ to $4$ weeks after the initial infection.

Poststreptococcal Glomerulonephritis

A non-suppurative complication involving injury to the glomerulus due to immune complex deposition occurring $1$ to $2$ weeks after GABHS infection.

PANDAS

Pediatric Autoimmune Neuropsychiatric Disorder Associated with group A Streptococcal infection, involving an abrupt onset of obsessive-compulsive behaviors or tics.

Modified Centor Score

Also known as the McIsaac Score, a tool that uses features like absence of cough, fever, tonsillar exudates, lymphadenopathy, and age to predict the probability of streptococcal pharyngitis.

RADT

Rapid Antigen Detection Test, a point-of-care screen for streptococcal antigens.

Throat Culture

The gold standard for the diagnosis of streptococcal pharyngitis, with a false negative rate of $10\%$ or lower.

Infectious Mononucleosis

An infection usually caused by Epstein-Barr virus (EBV), common in ages $5$ to $25$ years, presenting with gradual onset, fatigue, and lymphadenopathy.

Splenomegaly

Enlargement of the spleen, occurring in $50\%$ of infectious mononucleosis cases, with a risk of splenic rupture in the first $3$ weeks.

Monospot Test

The best initial rapid screening test for EBV, which detects heterophil antibody agglutination.

Atypical Lymphocytosis

The presence of atypical lymphocytes in a white blood cell count, used as a clinical predictor for infectious mononucleosis.