Sore Throat

Question 1

What are the causes of an acute sore throat?

Answer 1

Acute pharyngitis, tonsillitis, or laryngitis.

Question 2

What are the pathogens that cause a sore throat?

Answer 2

1. Viral - rhinovirus, coronavirus, parainfluenza virus

2. Bacteria - group A B-haemolytic streptococcus

Question 3

What test should not be be done routinely in a sore throat?

Answer 3

Throat swabs

Question 4

What is this a presentation of?

Tonsillar exudate, tender lymphadenopathy, fever, absence of cough.

Answer 4

Bacterial sore throat

Question 5

What is this a presentation of?

Large, red tonsils. May or may not be coated in tonsillar exudate.

Answer 5

Tonsillitis

Question 6

What is this a presentation of?

Painful throat, dysphagia, pain on phonation, hoarseness

Answer 6

Laryngitis

Question 7

What is the treatment for viral sore throat?

Answer 7

Symptomatic relief - ibuprofen +/- paracetamol

Question 8

What is the treatment for bacterial sore throat?

Answer 8

1. Symptomatic relief - ibuprofen +/- paracetamol

2. Consider penicillin V for 10 days (macrolide for 5 days if allergic)

Question 9

What are the indications for tonsillectomy?

Answer 9

1. > 7 documented episodes of sore throat preventing normal functioning.
2. Clinically significant tonsillitis in past year
3. 5 episodes in past 2 years
4. 3 episodes in 3 years
5. 2 episodes of quinsy

Question 10

What are the complications of tonsillitis and how are they managed?

Answer 10

1. Primary haemorrhage (<24 hrs) - return to theatre, ABCDE, FBC, cross-match, tranexamic acid
2. Secondary haemorrhage (5-10 days) - ENT emergency
3. Peritonsillar abscess (quinsy) - IV ben pen and metronidazole, IV dexamethasone, analgesia, aspiration under GA.