Psych & Sore Throat Flashcards
Is there evidence that sore throats a result of a bacterial cause are more severe than viral ones or that the duration of the illness is significantly different in either case.
No
How does fever relate to pharyngitis and tonsillitis?
Common
How does sore throat relate to dehydration?
Can be caused by reduced fluid intake and also cause dehydration.
At what point is reduced fluid intake an issue in infants and children?
Down by 50%
What is the FeverPain/Centor score used to assess?
Likelihood fo Group A Streptococcus
What are the components of the FeverPain score?
Purulence (pharyngeal/tonsillar exudate).
Attend rapidly (3 days or less)
Severely Inflamed tonsils
No cough or coryza
What are the components of the Centor score?
Tonsillar exudate
Tender anterior cervical lymphadenopathy or lymphadenitis
History of fever (over 38°C)
Absence of cough
What are the cut off scores for FeverPain/Centor?
4-5
5 common (non-step) causes of common sore throat
The common cold Influenza — Pharyngoconjunctival fever — Acute herpetic pharyngitis Infectious mononucleosis (glandular fever) ).
3 Rare but serious causes of sore throat?
Kawasaki
Epiglottitis
Measles
antibiotics for streptococcal sore throat decrease symptom duration by…?
Less than 1 day
For people not in a vulnerable group, and without severe symptoms, or who have a FeverPAIN score of 2 or 3, what would you consider?
Delayed antibiotic prescribing
What is the antibiotic of choice and allergy alternative for sore throat?
phenoxymethylpenicillin
Clarithromycin
Self care for sore throat
Fluids
NSAIDS for fever and pain relief
Avoid hot drinks
Medicated lozenges can give a bit of relief
How soon can kids return to school after sore throat?
Day after fever has resolved
Safety net for sore throat
Symptoms have not improved after 3 or 4 days of antibiotic therapy
Pain does not improve after 3 days, and/or there is fever over 38.3°C
It becomes difficult to swallow saliva or liquids, if any difficulty in breathing develops, or if there is any one-sided neck or throat swelling
Two core questions for depression?
During the last month have you often been bothered by feeling down, depressed, or hopeless?
Do you have little interest or pleasure in doing things?
How long do at least one of the “core” symptoms of depression have to be present for?
most days, most of the time, for at least 2 weeks
7 associated features of depression
Disturbed sleep (decreased or increased compared to usual).
Decreased or increased appetite and/or weight.
Fatigue/loss of energy.
Agitation or slowing of movements.
Poor concentration or indecisiveness.
Feelings of worthlessness or excessive or inappropriate guilt.
Suicidal thoughts or acts
Are investigations routinely indicated for depression?
No
5 Medical conditions that may present as depression?
Anxiety Bipolar Dementia Parkinson's Hypothyroidism
4 questions to assess risk of suicide?
Do you have thoughts about death or suicide?
Do you feel that life is not worth living?
Have you made a previous suicide attempt?
Is there a family history of suicide?