Throat Problems

Question 1

viral causes of acute tonsilitis

Answer 1

EBV
rhinovirus
influenza
parainfluenza
enterovirus
adenovirus

Question 2

bacterial causes of acute tonsilitis

Answer 2

strep pyogenes (GABHS)

Question 3

risks in strep pyogenes

Answer 3

rheumatic fever

GM

Question 4

presentation of viral tonsilitis

Answer 4

malaise
sore throat
temperature
able to undertake normal activity
possible lymphadenopathy
lasts 3-4 days

Question 5

presentation of bacterial tonsilitis

Answer 5

systemic upset
fever
odynophagia
halitosis
unable to work
lymphadenopathy
lasts a week

Question 6

CENTOR criteria for tonsilitis

Answer 6

history of fever
tonsillar exudates
tender anterior cervical lymphadenopathy
absence of cough

<15 add 1 point and >44 subtract 1 point

Question 7

when should antibiotics be given in tonsilitis?

Answer 7

score on CENTOR criteria of 4-5

Question 8

supportive management of tonsilitis

Answer 8

eat
drink
rest
analgesia (paracetamol, NSAIDs)

Question 9

antibiotic management of tonsilitis

Answer 9

penicillin 10 days (clarithromycin if allergic)

surgery if 7 cases in 1 year

Question 10

what is peritonsillar abscess a complication of?

Answer 10

tonsilitis

Question 11

what is a peritonsillar abscess?

Answer 11

bacteria becomes lodged in posterior capsule

Question 12

presentation of peritonsillar abscess

Answer 12

3-7 days acute tonsilitis
unilateral throat pain/ odynophagia
trismus (reduced opening of jaw)
tonsils and uvula displaced (palate bulges out, so tonsil is no longer seen and concavity of palate is lost)

Question 13

management of peritonsillar abscess

Answer 13

antibiotics

Question 14

two causes of obstructive hyperplasia

Answer 14

1. adenoids

2. tonsils

Question 15

presentation of obstructive hyperplasia caused by adenoids

Answer 15

obligate mouth breathing
hypo-nasal voice
snoring
sleep disturbance
AOM/OME

Question 16

presentation of obstructive hyperplasia caused by tonsils

Answer 16

snoring
muffled voice
sleep disturbance
dysphagia

Question 17

what is infectious mononucleosis?

Answer 17

glandular fever caused by EBV

Question 18

presentation of infectious mononucleosis

Answer 18

gross tonsillar enlargement with membrane exudates
cervical and generalised lymphadenopathy
palatal petechial haemorrhages
jaundice
hepatosplenomegaly

Question 19

diagnosis of infectious mononucleosis

Answer 19

FBC= atypical lymphocytes, low CRP <100 and deranged LFTs

monospot or paul-bunnell test

Question 20

management of infectious mononucleosis

Answer 20

supportive

systemic steroids if failing

Question 21

what should never be given to infectious mononucleosis?

Answer 21

amoxicillin

results in macular rash

Question 22

what is epiglottitis?

Answer 22

inflammation of the epiglottis

Question 23

what is the most common cause of epiglottitis?

Answer 23

H. influenza B

Question 24

presentation of epiglottitis

Answer 24

severe sore throat
drooling saliva
pyrexia
can have stridor

Question 25

diagnosis of epiglottitis

Answer 25

examination of oral cavity is normal

Question 26

management of mild epiglottitis

Answer 26

supportive
nebulisers (adrenaline/ saline)
steroids

Question 27

management of severe epiglottitis

Answer 27

antibiotics
intubation
ventilation
tracheostomy

Question 28

causes of recurrent respiratory papillomatosis

Answer 28

HPV6 and 11