Acute Sore Throat

Question 1

3 regions of the pharynx

Answer 1

Nasopharynx
Oropharynx
Laryngopharynx

Question 2

Signs and symptoms for Sore throat

Answer 2

Otalgia (earache), coryzal (inflammation of mucous membranes), cough, night sweat, odynophagia, SOB, feer, tachycardia, weight loss, dysphagia, drooling, stridor, diarrhoea

Question 3

Viral causes of pharyngitis

Answer 3

Rhinovirus, adenovirus, para-influenza

Question 4

Bacterial causes of pharyngitis

Answer 4

Group A B-haemolytic strep (exudate)

Question 5

Fungal causes of pharyngitis

Answer 5

Candida present by white spots

Question 6

Investigation for pharyngitis

Answer 6

Throat culture, rapid antigen detection test, chest X ray if cough is persistent, bloods

Question 7

Management for pharyngitis

Answer 7

Oral fluids, Analgesia, antibiotics

Question 8

When to do an elective tonsillectomy

Answer 8

> 7 episodes in the last 12 months
5 episodes every year for the past 2 years
3 episodes every year for the past 3 years

Question 9

Peritonsillar Absillar aka Quinsy

Answer 9

Pus due to an infection behind the tonsil and untreated tonsilitis

Question 10

Who is commonly affected by Quinsy

Answer 10

Children, Adolescents, young adults

Question 11

Bacterial causes of Quinsy

Answer 11

Streptococcal, Staphylococcal, Haemophilus, fusobacterium necrophorum

Question 12

Investigations for Quinsy

Answer 12

Bloods: FBC, CRP

Question 13

Treating Quinsy

Answer 13

Benzylpenicillin, needle aspiration, incision and drainage, tonsillectomy

Question 14

Infectious Mononucleosis aka Glandular fever, Kissing Disease

Answer 14

Viral infection caused by the Epstein-Barr Virus.

10% of acute tonsillitis

Question 15

Symptoms of Glandular fever

Answer 15

Sore throat, fever, swollen glands and fatigue, skin rash, loss of appetite, puffiness, pain in upper abdomen, liver pain and jaundice

Question 16

Treating Glandular fever

Answer 16

There is no cure. Will disappear within 4-6 weeks.

Drink fluids, rest, painkillers, gargle with salt water, corticosteroids to reduce inflammation

Question 17

Investigating Glandular Fever

Answer 17

Assess lymph nodes, tonsils, liver and spleen.
Antibody test to detect specific antibodies.
White blood cell test

Question 18

Complication of glandular fever

Answer 18

Splenic rupture, pneumonia, menigitis, encephalitis, haemolytic anaemia, myocarditis

Question 19

Advice for patients with Glandular fever

Answer 19

If damaged spleen avoid contact sports for 6 weeks

Question 20

Difference between Supraglottitis and Epiglottitis

Answer 20

Supraglottitis in adults and Epiglottitis in children

Question 21

Cause of supraglotittis

Answer 21

Haemophilus influenzae, Stretococcus pneumoniae, Group A Strep

Question 22

Cause of epiglottitis

Answer 22

Group A beta-haemolytic strep, Streptococcus pneumoniae, Haemophilus influenzae type B

Question 23

Presentation of epiglotittis

Answer 23

Drooling in children, SOB in adults, sore throat

Question 24

Investigating epiglottis

Answer 24

Airway assessment, blue light to A&E, urgent ENT assessment

Question 25

Treating Epiglotittis

Answer 25

Secure airway: adrenaline nebulisers, IV dexamethasone, intubate, cricothyroidotmy, tracheostomy

Treat cause: IV cefotaxime