Throat Infections

Question 1

What is a quinsy?

Answer 1

Peri-tonsillar abscess

Question 2

What is the most common bacterial cause of ‘sore throat’?

What complications can this cause?

Answer 2

Strep pyogens - gram positive

Rheumatic fever
Glomerulonephritis

Question 3

Is a sore throat more likely to be caused by bacteria or virus?

Answer 3

Virus (over 2/3rds)

Question 4

What is the classic triad of EB virus?

Answer 4

• Fever
• Lymphadenopathy
• Pharyngitis

Question 5

What can be seen on the soft palate in EB viral infections?

Answer 5

Palatal petectiae

- lil red spots

Question 6

Describe the rash appearance in EB?

Answer 6

Widespread rash when STARTING ABs

Question 7

Throat swabs should be carried out routinely in primary care for anyone presenting with sore throat. T/F?

Everyone should be given ABs?

Answer 7

F

Only give ABs if appropriate

Question 8

What will happen to a patient who is admitted to hospital with strep throat?

What AB is given to treat?

Answer 8

Will be in isolation for 48hrs

Penicillin

Question 9

If a teen/YA patient with sore throat which takes a long time to resolve + severe lethargy. What should be suspected?

Answer 9

EB Virus

Question 10

Is absence of a cough more indicative of viral or bacterial infection?

Answer 10

Bacterial

Question 11

What is the score system which can be used to differentiate between bacterial and viral cause of ‘sore throat’?

describe it and link to AB prescribing

Answer 11

Fever PAIN

Fever (last 24hrs)
Purulence
Attend rapidly (within 3/7)
very Inflammed tonsils
No cough/coryza 

• more points = more likely to be bacterial/ need ABs

0-1 = no ABs
2/3 = consider ABs/ backup (send prescription - if no improvement in 3-5 days go collect)
4/5 = immediate ABs

Question 12

What drug can cause neutropenia and hence sore throat are v dangerous?

Answer 12

Carbimazole

Question 13

What AB should be prescribed if FeverPAIN score 4/5?

Answer 13

phenoxymethylpenicillin/clarithromycin

Question 14

Patient presents with severe sore throat with a grey white membrane across the pharynx?

Answer 14

Diptheria

Question 15

What WBC is abnormal in EB virus?

Answer 15

Lymphocytes

Question 16

What GI complication can occur in EB virus?

Answer 16

Splenic rupture

Hepatomegaly

Jaundice

Question 17

How is EB virus diagnosed?

Answer 17

Monospot

Question 18

Candida albicans infected throat.

How will this appear?

How is it treated?

Answer 18

White patches on red - easily scraped off

Fungal infection which can occur post ABs/after inhaled steroids etc.

Nystatin liquid

Question 19

How many episodes of tonsillitis is indicative of tonsillectomy?

Answer 19

5+ over 2 years

Or causing disruption to daily life e.g. stopping you going to uni etc

Question 20

How is glandular fever differeniated from tonsilitis when looking at throat?

Answer 20

Glandular fever is much more swollen and a membranous exudate

Question 21

A patient who has just had a tonsillectomy has light bleeding from the injury site on observation. How is this patient managed?

Answer 21

Immediate back to surgery

haemorrhage is a major complication of tonsillectomy

Question 22

How long is the AB treatment course for tonsillitis?

Answer 22

7 or 10 days