Sore throat Flashcards
If a pt presents with swollen anterior cervical glands, high grade fever and absence of a cough, what could this suggest? Should this pt be referred?
bacterial infection - streptococcal sore throat
Only if the pt experiences 3 or all four symptoms
What symptoms do pts get when they have glandular fever?
pharyngitis, fever, cervical lymphadenopathy, general malaise
What questions would you ask someone who has a sore throat and why?
- Age of pt - streptococcus is uncommon under 3 years, glandular fever is common in adolescents
- Tender cervical glands - glandular fever and streptococcal sore throat have markedly swollen glands
- Tonsillar exudate present - more bacterial than viral
- Ulceration - herpes simplex ulcers
Which drugs can cause a sore throat and may be associated with agranulocytosis?
Captopril, carbimazole, cytotoxics, neuroleptics, penicillamine, sulfasalazine, sulphur-containing antibiotics
When would you refer a pt with a sore throat?
- Sore throat lasting more than 10 days or 2 weeks
- extreme pain especially in the absence of a cold cough and catarral symptoms and symptoms lasting over 1-2 days
- difficulty in swallowing
- certain drugs like the ones that can cause agranulocytosis
- white plaques in the throat gums or tongue
- Red and swollen tonsils and/or swollen lymph glands
What are tx options for pts with a sore throat? Name exmaples.
- local anaesthetics - lidocaine, benzocaine sprays or lozenges
2.
What ages can lidocaine and benzocaine be given? How often would you use it? Is it safe to use in pregnancy and BF?
- > 12 years - three sprays every 3 hours when needed up to a max of 6 times a day
- lozenge >3 years (tyrozets - child:1 lozenge every 3 hours max of 6, adults: max of 8 in 24 hours), spray >6 years - ultrachloraseptic spray - one spray every 2-3 hours
YES
Name an anti-inflammatory sore throat medicine and what ages can it be used?
benzydamine
rinse >12 years - rinse every 1.5 -3 hours when required
spray >6years - same ^ 6-12 years use 4 puffs, adults: 4-8 puffs
Name lozenge anti-inflammatory.
flurbiprofen (strefen) - suck one every 3-6 hours with a maximum of 5 lozenges in 24 hours
What are the age restrictions and who should you avoid using flurbiprofen lozenge?
> 12 years
avoid in pts with peptic ulcers and in pregnancy