Throat Disease Flashcards
what are the four things on the centor criteria?
history of fever
tonsils exudates
tender anterior cervical lymphadenopathy
absence of cough
what is done if someone has less than 2 points on the centor score?
no antibiotic or culture needed
what is done if someone has 2-3 points on the centor score?
throat culture
treat if culture positive
what is done if someone has >3 on the centor score?
treat with an antibiotic
in the modified centor score, what is done if someone is under the age of 15?
add a point
in the modified centor score, what is done if someone is over the age of 44?
subtract a point
what is the most common causes of tonsillitis?
viruses
what are the three most common bacterial causes of tonsillitis?
strep pyogenes
h influenza
staph aureus
what is quinsy?
a peritonsillar abscess
what are the symptoms of a viral tonsillitis?
malaise
sore throat
temperature
how long does viral tonsillitis last?
3-4 days
what are the symptoms of a bacterial tonsillitis?
systemic upset
fever
odynophagia
halitosis
how long does bacterial tonsillitis last?
around a week
how is bacterial tonsillitis managed?
antibiotics
what score is used to determine if people need antibiotics for tonsillitis?
feverPAIN
what are the five criteria in the feverPAIN score?
fever purulence attend rapidly severely inflamed tonsils no cough/coryza
what supportive management is recommended for tonsillitis?
eat and drink
rest
analgesia
what antibiotics are given for tonsillitis?
penicillin 500mg for 10 days
clarithromycin if penicillin allergic
what antibiotic should not be given for tonsillitis and why?
amoxicillin
could be glandular fever. - causes a reaction
what is the a risk of in tonsillectomy?
haemorrhage
what is quinsy a complication of?
acute tonsillitis
what causes quinsy?
bacteria gets in between the muscle and the tonsil and starts to produce pus
how does quinsy present?
unilateral throat pain
odynophagia
trismus
what is seen upon examination of the mouth in quinsy?
medial displacement of the tonsil
uvula displaced away from the affected side
how is quinsy managed?
aspiration of pus
antibiotics
what is another name for glandular fever?
infectious mononucleosis
what causes glandular fever?
epstein barr virus (EBV)
how is glandular fever diagnosed?
atypical lymphocytes
positive monospot or paul bunnell test
low CRP
how is glandular fever managed?
symptomatic treatment
antibiotics
steroids
what does giving amoxicillin in glandular fever cause?
a generalised macular rash
what can be affected by obstructive hyperplasia?
adenoids
tonsils
how does obstructive hyperplasia of the adenoids present?
mouth breathing
hypo nasal voice
sleep apnoea
how does obstructive hyperplasia of the tonsils present?
sleep apnoea
muffled voice
what are other names for glue ear?
otitis media with effusion (OME)
serous otitis media (SOM)
what is glue ear?
inflammation of the middle ear accompanied by accumulation of fluid
who is more commonly affected by glue ear?
more common in males
children
what are the risk factors for glue ear?
nursery
older siblings
smoking households
recurrent URTI’s
what are the symptoms of glue ear?
hearing loss
learning and behaviour problems
speech delay
what is the initial management of glue ear?
watchful waiting for three months
if not better at three months, what should be done for glue ear?
review and do further/repeat investigations
when is glue ear referred?
persistent >3/12
conductive hearing loss
speech problems
what is the surgical management for glue ear under 3 years?
grommets
what is the surgical management for glue ear in people over 3 who have not had interventions before?
grommets
what is the surgical management for glue ear in people over 3 who have had interventions before?
grommets
adenoidectomy
