GP conditions - respiratory

Question 1

What is used to determine the probability that tonsilitis is caused by a bacterial infection ?

Answer 1

FEVER pain

FEVER in last 24 hours
P : purulent tonsils
A : attended within 3 days of symptoms
I : Inflamed tonsils
N : no cough or coryzal symptoms

Question 2

what is the most common bacterial cause of tonsilitis

Answer 2

• Streptococcus bacteria

Question 3

What antibiotic is given for tonsiltitis caused by strep bacteria ?

Answer 3

• Penicillin V
• If allergic : clarithromycin or erythromycin

Question 4

Give 4 complications of tonsilitis

Answer 4

• Otitis media
• Quinsy
• Acute nephritis (post strep glomerulonephritis)
• Acute rheumatism

Question 5

Give one complication of strep A infection

Answer 5

Scarlett fever

Question 6

How does scarlett fever present

Answer 6

• Preceding tonsilitis
• 12 to 48 hrs later = rough sandpaper like rash

Question 7

Give 5 common clinical features of scarlett fever

Answer 7

1. High fever
2. White coating on the tongue which peels leaving a strawberry tongue
3. Cervical lymphadenoapathy
4. Flushed face, pale around the mouth
5. Desquamation on soles of feet and the hands

Question 8

How is scarlett fever managed and what is the school exclusion time ?

Answer 8

• 10 days of penicillin V (phenoxymethylpenicillin
• 24 hours from starting antibiotics

Question 9

4 year old children presents with smoky pepsi coloured unrin 7-14 days after suffering tonsillitis

Answer 9

• Post streptococcal glomerulonephritis

Question 10

what is a quinsy

Answer 10

• Collection of pus in the peritonsillar space (=peritonsillar abscess).

Question 11

Give 3 clinical features of a quinsy

Answer 11

• Severe dysphagia
• Trismus
• Referred earache

Question 12

How is a quinsy managed in ENT

Answer 12

• Systemic penicillin (strep infection)
• Drainage of abscess by aspiration or incision