Sore Throat Flashcards
What is it?
Encompasses tonsillitis, pharyngitis and laryngitis
What is the FeverPain score?
1 for each of following
Fever
Purulence- exudate on tonsils
Attend within 3 days of symptom onset
Inflamed tonsils
No coryzal symptoms
More points= higher chance of strep throat infection
What is the CENTOR criteria?
1 point for each
Cervical Lymph nodes
Exudate on tonsils
No cough
Temperature >38
Score of 3 to 4 indicates higher chance of throat infection
What is the management of tonsillitis?
FeverPAIN score >4 or Centor Score >3 then abx
1) Pen V
- if pen allergic then clarithromycin (erythro if pregnant)
What is the criteria for tonsillectomy?
7 episodes per year for one year
5 episodes per year for 2 years
3 episodes per year for 3 years
Features of sore throat are disabling
Recurrent febrile convulsions due to tonsillitis
OSA
At least 2 episodes of quinsy
What is features of Quinsy?
Most common in children aged 2-5
Systemic upset- fever
Sore throat
Trismus- muffled hot potato voice
Uvular deviation away from quinsy
Hallitosis
Admission
IV abx
Needle aspiration
What is Glandular Fever?
Caused by EBV
Spread via saliva
Has an acute infection followed by long term low grade illness
More common in teens/young adults
What are clinical features of glandular fever?
Prodromal symptoms
- myalgia, malaise, fatigue, sweats
Non specific rash- triggered post amoxiciilin
Pyrexia
Severely sore throat
O/E
- lymphadenopathy
- enlarged tonsils- may come together, whitewash
- Palpable splenomegaly
- RUQ tenderness/hepatomegaly
What investigations are needed for glandular fever?
If <12 years or immunocompromised
- bloods check EBV serology after 1 week
If >12 years and no history of immunocompromise
- FBC and monospot test in week 2
- If monospot negative repeat in 5-7 days
Transaminitis- AST/ALT are usually derranged
What is the management of glandular fever?
Supportive management
Avoid contact sport or heavy lifting to avoid splenic rupture
