gp

Question 1

what are the centor criteria?

Answer 1

criteria for assessing the likelihood that tonsilitis is caused by bacteria.
components:
-Fever >38
-Tonsillar exudate
-absence of cough
-tender anterior cervical lymphadenopathy

Question 2

how would you treat bacterial tonsilitis ?

Answer 2

• analgesia (paracetamol)

- benzylpenicillin

Question 3

what is the most common cause of bacterial tonsillitis

Answer 3

group A beta haemolytic strep

Question 4

tonsillitis differentials

Answer 4

• infectious mononucelosis
• epiglottitis
• peritonsillar abscess
• retropharyngeal abscess

Question 5

what investigations might you do if you suspect tonsillitis?

Answer 5

• rapid strep antigen test
• throat culture
• wcc etc

Question 6

how would you counsel someone on inhaler technique?

Answer 6

-shake inhaler
-breathe out gently as much as poss
-make tight seal w lips
-press down and breathe in deeply
hold breath as long as poss (10 secs)
-repeat
-put cap on

if steroids then rinse mouth out to prevent thrush
get the patient to show you, then tweak their technique whilst outlining positive aspects first!

Question 7

how would you counsel someone on a spacer?

Answer 7

• attach device
• breathe out as much as poss
• make tight seal around the mouth piece
• press down on inhaler
• take a number of normal breaths in and out

clean spacer at least monthly. let it drip dry- do not wipe
replace spacer at least every year

Question 8

as a gp what advice can you give to someone hoping to get pregnant?

Answer 8

• keep active and eat well
• BMI <30
• take folic acid (400mcg OD) and if med issues 5mg
• may need vitamin D supplements
• stop smoking and alcohol
• check up to date with MMR