Pharyngitis - Revision history

JenniferH: /* Resources/References */

2021-09-22T18:14:52Z

Resources/References

← Older revision		Revision as of 18:14, 22 September 2021
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	===Resources/References===		===Resources/References===
	* [[media:GAS_Guideline.pdf\|Group A Strep Pharyngitis: Evaluation & Treatment YKHC Clinical Guideline]]		* [[media:GAS_Guideline.pdf\|Group A Strep Pharyngitis: Evaluation & Treatment YKHC Clinical Guideline]]
			*[https://www.mdcalc.com/centor-score-modified-mcisaac-strep-pharyngitis mdcalc Centor Score (Modified) Calculator]


	[[:Category:YKHC Guidelines\|YKHC Clinical Guidelines]]		[[:Category:YKHC Guidelines\|YKHC Clinical Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]
	~~<br/>[https://www.mdcalc.com/centor-score-modified-mcisaac-strep-pharyngitis mdcalc Centor Score (Modified) Calculator]~~

JenniferH: /* Resources/References */

2021-09-22T18:14:09Z

Resources/References

← Older revision		Revision as of 18:14, 22 September 2021
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	[[:Category:YKHC Guidelines\|YKHC Clinical Guidelines]]		[[:Category:YKHC Guidelines\|YKHC Clinical Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]
			<br/>[https://www.mdcalc.com/centor-score-modified-mcisaac-strep-pharyngitis mdcalc Centor Score (Modified) Calculator]

JenniferH at 06:22, 19 November 2020

2020-11-19T06:22:54Z

← Older revision		Revision as of 06:22, 19 November 2020
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	Clinical onset in older children and adults is abrupt onset of ST, HA, malaise and feverish.		Clinical onset in older children and adults is abrupt onset of ST, HA, malaise and feverish.

	The pharynx is usually red and edematous with hyperic/hyperplastic tonsils with white exudate, tender lymphadenopathy, and T>101. Symptoms usually last 3-5 days. It may develop into a peritonsillar abscess – with a enlarged asymmetrical tonsil – exquisitely tender. This may need to be drained by needle aspiration.		The pharynx is usually red and edematous with hyperic/hyperplastic tonsils with white exudate, tender lymphadenopathy, and T>101. Symptoms usually last 3-5 days. It may develop into a peritonsillar abscess – with an enlarged asymmetrical tonsil – exquisitely tender. This may need to be drained by needle aspiration.
	Exudative pharyngitis in children less than 3 is rarely streptococcal. Type specific antibodies are seen in 4-8 weeks and protect against infection with organisms of the same M-type.		Exudative pharyngitis in children less than 3 is rarely streptococcal. Type specific antibodies are seen in 4-8 weeks and protect against infection with organisms of the same M-type.

JenniferH at 06:21, 19 November 2020

2020-11-19T06:21:09Z

← Older revision		Revision as of 06:21, 19 November 2020
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	Evaluate for dehydration – as some of our severely ill patients require IV fluids – as they are so dehydrated due to decreased oral intake from the pain.		Evaluate for dehydration – as some of our severely ill patients require IV fluids – as they are so dehydrated due to decreased oral intake from the pain.
	If a peritonsillar abscess looks likely – it will need to be drained with needle aspiration – using hurricane spray for numbing. Ask for assistance with this as it can be tricky.		If a [[Peritonsillar Abscess\|peritonsillar abscess]] looks likely – it will need to be [[Peritonsilar Abscess Drainage\|drained with needle aspiration]] – using hurricane spray for numbing. Ask for assistance with this as it can be tricky.

	Be aware that there can many complications from strep – and a review of common complications and management is important.		Be aware that there can many complications from strep – and a review of common complications and management is important.

	'''~~Referral to ENT~~'''		'''Recurrent Strep Infections'''
	* Review chart for recurrent RST. If patient meets Diagnostic Criteria and parent desires, refer to ENT for tonsillectomy.		* Review chart for recurrent RST. If patient meets Diagnostic Criteria and parent desires, refer to ENT for tonsillectomy.
	**Order: "Refer to ENT External - Tonsillectomy"		**Order: "Refer to ENT External - Tonsillectomy"
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	***Repeat hospitalization for tonsillitis		***Repeat hospitalization for tonsillitis
	***Sleep disorder breathing 2/2 hypertrophy		***Sleep disorder breathing 2/2 hypertrophy
	**If the patient does not meet these criteria, but you or the parent still have concerns, consider placing referral to ENT internal		**If the patient does not meet these criteria, but you or the parent still have concerns, consider placing a referral to ENT internal
	***Order: "Refer to ENT Internal"		***Order: "Refer to ENT Internal"
	***This will put the patient on the queue to be seen by ENT in their Bethel Field Clinic, but may be several clinics before they can be scheduled as they are often full.		***This will put the patient on the queue to be seen by ENT in their Bethel Field Clinic, but may be several clinics before they can be scheduled as they are often full.

JenniferH at 06:17, 19 November 2020

2020-11-19T06:17:24Z

← Older revision		Revision as of 06:17, 19 November 2020
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	Be aware that there can many complications from strep – and a review of common complications and management is important.		Be aware that there can many complications from strep – and a review of common complications and management is important.

			'''Referral to ENT'''
	* Review chart for recurrent RST. If patient meets Diagnostic Criteria and parent desires, refer to ENT for tonsillectomy.		* Review chart for recurrent RST. If patient meets Diagnostic Criteria and parent desires, refer to ENT for tonsillectomy.
	**Order: "Refer to ENT External - Tonsillectomy"		**Order: "Refer to ENT External - Tonsillectomy"

JenniferH at 06:16, 19 November 2020

2020-11-19T06:16:54Z

@@ Line 13: / Line 13: @@
 If a peritonsillar abscess looks likely – it will need to be drained with needle aspiration – using hurricane spray for numbing. Ask for assistance with this as it can be tricky.
 Be aware that there can many complications from strep – and a review of common complications and management is important.
 ===Resources/References===

JenniferH: /* Resources/References */

2020-11-16T18:12:31Z

Resources/References

← Older revision		Revision as of 18:12, 16 November 2020
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	* [[media:GAS_Guideline.pdf\|Group A Strep Pharyngitis: Evaluation & Treatment YKHC Clinical Guideline]]		* [[media:GAS_Guideline.pdf\|Group A Strep Pharyngitis: Evaluation & Treatment YKHC Clinical Guideline]]

	[[:Category:YKHC Guidelines]]
			[[:Category:YKHC Guidelines\|YKHC Clinical Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

JenniferH: /* Resources/References */

2020-11-16T18:12:03Z

Resources/References

← Older revision		Revision as of 18:12, 16 November 2020
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	===Resources/References===		===Resources/References===
	* [[media:~~GAS_guideline~~.pdf\|Group A Strep Pharyngitis: Evaluation & Treatment YKHC Clinical Guideline]]		* [[media:GAS_Guideline.pdf\|Group A Strep Pharyngitis: Evaluation & Treatment YKHC Clinical Guideline]]

	[[:Category:YKHC Guidelines]]		[[:Category:YKHC Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

JenniferH: /* Resources/References */

2020-11-16T18:11:38Z

Resources/References

← Older revision		Revision as of 18:11, 16 November 2020
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	===Resources/References===		===Resources/References===
	* [[media:~~Pharyngitis~~.pdf\|Pharyngitis ~~(Adults and Pediatrics)~~ YKHC Clinical Guideline]]		* [[media:GAS_guideline.pdf\|Group A Strep Pharyngitis: Evaluation & Treatment YKHC Clinical Guideline]]

	[[:Category:YKHC Guidelines]]		[[:Category:YKHC Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

JenniferH at 04:30, 25 September 2020

2020-09-25T04:30:14Z

← Older revision		Revision as of 04:30, 25 September 2020
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	If a peritonsillar abscess looks likely – it will need to be drained with needle aspiration – using hurricane spray for numbing. Ask for assistance with this as it can be tricky.		If a peritonsillar abscess looks likely – it will need to be drained with needle aspiration – using hurricane spray for numbing. Ask for assistance with this as it can be tricky.
	Be aware that there can many complications from strep – and a review of common complications and management is important.		Be aware that there can many complications from strep – and a review of common complications and management is important.

			===Resources/References===
			* [[media:Pharyngitis.pdf\|Pharyngitis (Adults and Pediatrics) YKHC Clinical Guideline]]

	[[:Category:YKHC Guidelines]]		[[:Category:YKHC Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]