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Quizzes > Quizzes for Business > Healthcare

Emergency Medicine Head and Neck Infection Quiz

Challenge Your Head and Neck Infection Skills

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art depicting a quiz on Emergency Medicine Head and Neck Infection

Welcome to the Emergency Medicine Head and Neck Infection Quiz, designed to sharpen your diagnostic and management skills. Ideal for residents, students, and ED practitioners, this quiz offers 15 thought-provoking questions to test your knowledge. You can compare and enhance your expertise by exploring our Emergency Medicine MCQ Quiz or boost infection control insights with the Infection Control Knowledge Quiz. Feel free to adapt any question in our quizzes editor to suit your learning goals.

Which pathogen is most commonly associated with peritonsillar abscesses?
Group A Streptococcus
Haemophilus influenzae
Escherichia coli
Staphylococcus aureus
Group A Streptococcus is the most frequent pathogen isolated in peritonsillar abscesses. Other bacteria like S. aureus and H. influenzae are less commonly involved in this deep oropharyngeal infection.
Ludwig's angina typically originates from infection of which anatomical structure?
Parotid gland
Maxillary incisor tooth
Mandibular molar tooth
Submental lymph node
Ludwig's angina most often arises from odontogenic infections of the mandibular molars. These infections can spread bilaterally into the submandibular and sublingual spaces.
A patient with peritonsillar abscess typically presents with which characteristic voice?
Hoarse whisper
Breathless whisper
Muffled "hot potato" voice
Strained high-pitched voice
Peritonsillar abscess causes swelling that distorts the oropharynx, resulting in a muffled or "hot potato" voice. Other voice changes are not characteristic of this condition.
What is the best initial imaging study to evaluate a suspected deep neck space infection in an adult?
MRI of the neck without contrast
Ultrasound of the neck
Contrast-enhanced CT scan of the neck
Plain radiograph of the chest
A contrast-enhanced CT scan provides excellent detail in evaluating both the extent of deep neck infections and differentiating abscess from cellulitis. MRI and ultrasound are less practical as initial studies in emergency settings.
Which antibiotic is first-line therapy for a mild peritonsillar abscess in an otherwise healthy patient?
Vancomycin
Amoxicillin-clavulanate
Ciprofloxacin
Azithromycin
Amoxicillin-clavulanate covers common aerobic and anaerobic oral pathogens in peritonsillar abscesses. Vancomycin and fluoroquinolones are reserved for resistant organisms or specific indications.
Which organism is most frequently isolated in Ludwig's angina?
Pseudomonas aeruginosa
Bacteroides fragilis
Staphylococcus aureus
Streptococcus viridans
Streptococcus viridans, part of the normal oral flora, is a common isolate in Ludwig's angina. Anaerobes contribute as well, but viridans streptococci are most frequent.
On contrast CT of a suspected deep neck space infection, which finding best suggests abscess formation?
Diffuse fat stranding without focal fluid
Enlarged lymph nodes without enhancement
A well-defined, rim-enhancing fluid collection
Calcified mass in tissue planes
A rim-enhancing fluid collection on contrast CT is characteristic of an abscess cavity. Diffuse fat stranding suggests cellulitis rather than an encapsulated abscess.
In a patient with risk factors for MRSA presenting with a deep neck infection, the antibiotic regimen should include:
Cephalexin alone
Doxycycline alone
Vancomycin
Amoxicillin alone
Vancomycin provides effective coverage against MRSA and is indicated when MRSA risk is present. Cephalexin and amoxicillin do not reliably cover MRSA.
Which of the following is a key systemic risk factor for developing deep neck space infections?
Asthma
Diabetes mellitus
Hypertension
Hyperlipidemia
Diabetes mellitus impairs host immunity and increases susceptibility to severe infections, including deep neck space infections. Other conditions listed are less directly linked to these infections.
In peritonsillar abscess, the uvula typically deviates:
Toward the affected side
Straight, without deviation
Away from the affected side
Inferiorly only
The expanding abscess pushes the tonsillar tissue and adjacent structures, causing the uvula to deviate away from the side of the lesion. Deviation toward the lesion does not occur.
For suspected jugular vein thrombosis in Lemierre's syndrome, the best initial imaging is:
Chest X-ray
Non-contrast MRI of the neck
CT venography of the neck
Ultrasound Doppler of the neck
CT venography provides detailed visualization of the venous structures and can identify thrombosis in the internal jugular vein. Ultrasound may miss deep or high cervical thromboses.
Which clinical feature is most characteristic of Ludwig's angina?
Pitting edema of the neck
Unilateral fluctuant neck mass
Bilateral submandibular swelling with woody induration
Isolated tender lymphadenopathy
Ludwig's angina presents with a firm, 'woody' induration of the bilateral submandibular spaces. It is a cellulitis rather than a fluctuant abscess initially.
Empirical antibiotic therapy for Ludwig's angina should cover:
Fungal pathogens
Anaerobes and streptococci
Gram-negative rods only
MRSA only
Ludwig's angina involves the mixed oral flora, especially anaerobes and Streptococcus species. Broad-spectrum coverage of these organisms is essential.
After needle aspiration of a small peritonsillar abscess in a stable patient, the next step is to:
Prescribe antibiotics and arrange follow-up
Initiate IV steroids alone
Discharge without treatment
Proceed directly to tracheostomy
After successful aspiration, patients should receive antibiotics covering oral flora and be followed closely. Airway intervention is not needed if the patient remains stable.
In a 6-year-old with suspected retropharyngeal abscess and minimal airway compromise, the most appropriate initial imaging is:
MRI of the neck
Ultrasound of the throat
Contrast-enhanced CT scan
Lateral neck radiograph
A lateral neck radiograph is a quick, readily available initial study in children to assess prevertebral soft-tissue swelling. CT is used when radiographs are inconclusive or airway compromise is severe.
Which finding is most indicative of Lemierre's syndrome?
Parotitis with Staphylococcus aureus
Group A streptococcal pharyngitis
Submandibular cellulitis
Fusobacterium necrophorum septic thrombophlebitis of the jugular vein
Lemierre's syndrome is characterized by Fusobacterium necrophorum infection leading to septic thrombophlebitis of the internal jugular vein. Other scenarios describe different infections.
In Ludwig's angina with signs of impending airway compromise, the recommended airway management is:
Nasotracheal trumpet insertion
Awake fiberoptic intubation
Rapid-sequence oral intubation without sedation
Application of cricoid pressure only
Awake fiberoptic intubation maintains spontaneous ventilation and allows careful visualization in distorted anatomy. Blind techniques risk complete airway obstruction.
A deep neck infection tracking through the retropharyngeal space can lead to which life-threatening complication?
Otitis externa
Cavernous sinus thrombosis
Descending necrotizing mediastinitis
Epiglottitis
The retropharyngeal space provides a direct path to the mediastinum, and infections can descend to cause mediastinitis. This is a highly morbid complication if not recognized early.
In a patient with Lemierre's syndrome and documented penicillin allergy, the most appropriate antibiotic choice is:
Ceftriaxone
Vancomycin
Clindamycin
Azithromycin
Clindamycin covers anaerobic organisms including Fusobacterium necrophorum and is safe in penicillin-allergic patients. Third-generation cephalosporins may cross-react in severe allergies.
Which laboratory marker is most predictive of a deep neck abscess requiring surgical drainage?
Mild leukopenia with normal CRP
Isolated elevated ESR with normal WBC
White blood cell count >15,000 cells/mm³
Normal inflammatory markers
A markedly elevated WBC count suggests a significant purulent collection and often correlates with abscess formation needing drainage. Normal or mildly elevated values are less predictive.
In patients with recurrent peritonsillar abscesses, which prophylactic intervention is recommended to reduce recurrence?
Repeated needle aspirations
Routine MRI screening
Interval tonsillectomy
Long-term macrolide prophylaxis
Interval tonsillectomy in patients with multiple peritonsillar abscess episodes effectively prevents recurrence by removing the primary site of infection. Repeat aspirations only manage acute episodes.
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Learning Outcomes

  1. Identify common pathogens responsible for head and neck infections in the emergency setting.
  2. Analyse clinical presentations of peritonsillar abscess and Ludwig's angina.
  3. Evaluate appropriate diagnostic imaging for deep neck space infections.
  4. Apply evidence-based antibiotic selection for head and neck infections.
  5. Demonstrate airway management considerations in severe infections.
  6. Interpret risk factors and prevention strategies for head and neck infections.

Cheat Sheet

  1. Spot the Usual Suspects - In head and neck infections, Group A Streptococcus, Staphylococcus aureus, and anaerobes like Fusobacterium often play the lead villains. Recognizing these microbial culprits helps you pick the perfect antibiotic superhero and leaves no room for guesswork. Learn more
  2. Spotting Peritonsillar Abscess - A sore throat, fever, a "hot potato" muffled voice, and trismus (jaw-lock) are your red flags. Early recognition means faster drainage, less pain, and happier patients ready to crunch into ice cream again. Learn more
  3. Ludwig's Angina Alarm - Rapid-onset submandibular swelling, an elevated tongue, and drooling can signal this dangerous infection. Airway compromise looms large, so knowing the signs ensures you jump into action before things get dicey. Learn more
  4. Picture Your Infection - Contrast-enhanced CT scans are your magical goggles for deep neck space infections. They reveal abscess pockets, track the spread, and guide your next move like a GPS for treatment planning. Learn more
  5. Antibiotic Dream Team - Combining penicillin with metronidazole gives you a tag team that knocks out both aerobic and anaerobic baddies in peritonsillar abscesses. This broad-spectrum duo minimizes treatment failures and keeps infections from staging a comeback. Learn more
  6. Airway First Aid - In Ludwig's angina, the airway can close faster than a trap door. Flexible nasotracheal intubation is often the hero move, but having surgical backup on standby is never a bad idea. Learn more
  7. Oral Hygiene Superpower - Poor dental hygiene and recent tooth infections are top risk factors for head and neck infections. Brushing, flossing, and regular dental check-ups aren't just for fresh breath - they're your first line of defense. Learn more
  8. Polymicrobial Party Crashers - Peritonsillar abscesses often host a mix of aerobes and anaerobes, so narrow-spectrum antibiotics won't cut it. Think broad-spectrum coverage to shut down the microbial mash-up. Learn more
  9. Sneaky Rapid Progression - Ludwig's angina can escalate in hours, sneaking up on you with airway obstruction. Early surgical drainage and IV antibiotics are your best defense against a medical emergency. Learn more
  10. Imaging: Your Sidekick - CT scans differentiate peritonsillar abscess from cellulitis or tonsillitis and guide needle aspiration or surgery. With clear imaging, you avoid blind procedures and plan targeted interventions. Learn more
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