Throat

Question 1

What is the most common causative organism in bacteial tonsillitis?

Answer 1

Group A streptococcus (Streptococcus pyogenes)

Question 2

What are the criteria of the centor criteria and what score warrants an antibiotic prescription?

Answer 2

Fever > 38 degrees
Tender anterior cervical lymphadenopathy
Tonsillar exudates
Absence of cough

Score of 3 or more = likely bacterial so offer antibiotics (phenoxymethylpenicillin aka Pen V - 10 day course) NOT AMOXICILLIN

Question 3

What criteria make up the FeverPAIN score?

Answer 3

Fever during previous 24 hours
P – Purulence (pus on tonsils)
A – Attended within 3 days of the onset of symptoms
I – Inflamed tonsils (severely inflamed)
N – No cough or coryza

Score 2-3: 34 – 40% probability of bacterial cause
Score 4–5: 62 – 65% probability of bacterial cause
Offer antibiotics if scoring 4 or more

Question 4

A vaccine to which organism has now reduced the incidence of epiglottitis in children?

Answer 4

Haemophilus influenza type B

Question 5

How may a patient’s voice be described in the classical presentation of epiglottitis?

Answer 5

‘Hot potato voice’ - sounds muffled