Sore Throat Flashcards
What is the difference between a sore throat and odynophagia?
A sore throat is a pain in the throat that worsens with swallowing. Odynophagia is a main that only occurs whilst swallowing
What are the main differential diagnoses of a sore throat?
- Viral pharyngitis
- Acute follicular tonsillitis
- Infectious mononucleosis (glandular fever)
- Candidiasis of buccal or oesophageal mucosa
- Agranulocytosis
What suggests that viral pharyngitis is the cause of sore throat?
- Pain on swallowing
- Fever
- Cervical lymphadenopathy
- Increased lymphocytes
- Normal or decreased leucocytes
What confirms that viral pharyngitis is the cause of a sore throat?
- Negative throat swab for bacterial culture
- Resolution within days
How is viral pharyngitis managed?
- Lozenges
- Paracetamol
What suggests that acute follicular tonsillitis is the cause of sore throat?
- Severe sore throat
- Pain on swallowing
- Fever
- Enlarged tonsils with white patches
- Cervical lymphadenopathy, especially in angle of jaw
- Increased leucocytes
What confirms that acute follicular tonsillitis is the cause of sore throat?
Positive throat swab for bacteria
How is acute follicular tonsillitis managed?
- Analgesic
- Antibiotics, e.g. penicillin, cephalosporin, or co-amoxiclav
What virus causes infectious mononucleosis?
Epstein-Barr
What suggests that infectious mononucleosis is the cause of sore throat?
- Very severe throat pain
- Enlarged tonsils covered in grey mucoid film
- Generalised lymphadenopathy
- Hepatomegaly
- Splenomegaly
What confirms that infectious mononucleosis is the cause of a sore throat?
- Increased atypical lymphocytes
- Paul-Bunnell or Monospot test result positive
- Viral titres
How is infectious mononucleosis managed?
- Lozenges
- Analgesics, e.g. paracetamol
What might happen if you give aspirin to a patient with infectious mononucleosis?
Reye’s syndrome
What suggests that candidiasis of the buccal or oesophageal mucosa is the cause of sore throat?
- Painful dysphagia
- White plaques
- History of immunosuppression, diabetes, or recent antibiotics
How is it confirmed that candidiasis or the buccal or oesophageal mucosa is the cause of sore throat?
- Oesophagoscopy showing erythema and plaques
- Brush cytology, with or without biopsy, showing spores and hyphae
