Sore Throat Flashcards
Differential for sore throat?
- tonsillitis
- pharyngitis
- Quinsy (complication of tonsillitis)
- ?Cancer
What are the causes of tonsilitis?
- Viral (HSV, EBV, RV, RSV (respiratory syncytial virus -50-80% ))
- Bacterial (group A haemolytic strep - most common)
How to tell the difference between bacterial and viral tonsilitis?
Bacterial is:
- more severe illness
- pyrexia is worse
- dysphagia
- anorexia
- malaise
- halitosis
- cervical lymphadenopathy
What is the criteria that is used for identifying tonsillitis in patients with Sore Throat presentation?
-Centor criteria
Cos centaurs have massive dicks so when they suck each other off they get a bare sore throat
What’s the centor criteria contain?
- Hx of fever
- tonsillar exudate
- tender anterior cervical lymph nodes
- absence of cough
+1 for <14, -1 for>44
What’s the scoring break down for the centor score?
- 0/1 - no photos
- 2/3 culture and treat if culture is +ve
- 4/5 - treat treat treat risk of strep high
What’s a bad tonsilitis?
-B haemolytic strep
How do you treat a B haemolytic strep tonsillitis?
- analgesia
- penyoxymethylpenicillin (Pen V) or clari/erythro if allergies
- rehydration
- ?admit
What investigations would you do for a patient ?admission with tonsillitis?
- throat swab + culture
- bloods -EBV testing (monospot or IgM/G)
- FBC (assume WCC)
When would you treat tonsillitis with steroids?
- dysphagia
- airway compromise
What is quinsy and how do you treat it?
- peritonsillar abscess
- Tx aspiration or I&D
Why are drs reticent to tx tonsillitis with a tonsillectomy?
- treats tonsillitis well but long term benefits contentious
- readmission with tonsillitis high
- abscess formation is high
What are the indications for tonsillectomy?
- > 7 episodes of bacterial tonsillitis in the last year
- 1 quinsy
- suspected malignancy (looks weird as fuck)
- disorder sleep breathing
