Sore Throat Flashcards

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1
Q

What is the most common cause of tonsillitis?

A

Viral

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2
Q

3 examples of viruses causing tonsillitis

A

EBV, HSV, adenovirus

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3
Q

What is the most common bacterial cause of tonsillitis?

A

Group A strep (strep pyogenes)

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4
Q

Centor criteria: purpose

A

Determines likelihood of bacterial tonsillitis (group A Strep)

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5
Q

4 parts of the centor criteria

A
  1. Tonsillar exudate
  2. Acute cervical lymphadenopathy
  3. Fever >38
  4. ABSENCE of cough
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6
Q

What centor score = strep infection likely?

A

3 or 4

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7
Q

5 parts of the feverPAIN score

A
  1. Fever >39
  2. Prurulence (exudate)
  3. Attend rapidly (<3 days)
  4. Inflamed tonsils
  5. No cough
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8
Q

For confirmed bacterial tonsillitis, what is the first line?

What would you give in penicillin allergy?

A

Phenoxymethylpenicillin (PEN V)

Pen allergy: clarithromycin

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9
Q

Which abx do you avoid in sore throat & why?

A

Avoid amoxicillin!! (can cause rash in EBV)

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10
Q

What mouthwash/ spray can be offered in tonisillitis?

A

Difflam mouthwash/ spray

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11
Q

What are the indications for referral for elective tonsillectomy?

A

> 7 episodes in the last year

OR >5 every year for past 2 years

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12
Q

What is quinsy?

A

AKA peritonsillar abscess

pain localised to one side of throat

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13
Q

Appearance of tonsils & uvula in quinsy

A

Bulging tonsil

Uvula displaced to one side

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14
Q

How is quinsy managed?

A

IV benzylpenicillin 1.2g (clarithromycin in allergy)

ENT referral for aspiration/ drainage

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15
Q

Sore throat differentials

A

Cold
Influenza
Glandular fever
Epiglottitis

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16
Q

Features of glandular fever

A

Pharyngitis >days

Adenopathy & splenomegaly

17
Q

Investigations in suspected glandular fever

A

MONOSPOT test & FBC for atypical lymphocytes = suggestive of glandular fever