the head so that the head does not move. The examiner can then lean over the child, holding a tongue blade in one hand and a light in the other.
Inspect the posterior pharynx. Inspect the size of the tonsils. Tonsillar size is estimated on a scale from 1+ to 4+, whereby 4+ indicates that the tonsils meet in the midline. ''Kissing'' tonsils (see Fig. 12-41) may be indicative of obstructive apnea. Is a purulent exudate present? Is a membrane present? Membranes are seen in diphtheria and Candida infections.
Are petechiae present? Streptococcal pharyngitis is often associated with petechiae. Inspect the posterior pharyngeal wall. A cobblestone appearance is suggestive of chronic postnasal drip.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.