TI3 - clinical uses of antibiotics Flashcards
What are the key symptoms and signs of epiglottitis, and how should it be managed?
Symptoms: severe sore throat, stridor, high fever, and the 4 D’s (dysphonia, drooling, dysphagia, distress).
Management: Call 999 immediately and avoid examining the throat as it can worsen airway obstruction.
What is the most common cause of a sore throat, and how is it usually treated?
Most sore throats are caused by viral infections, often related to the common cold.
Treatment is usually supportive with fluids, ibuprofen, paracetamol, and medicated lozenges. Antibiotics are generally not needed.
Why are antibiotics prescribed for sore throats caused by Group A Streptococcus (GAS)?
Antibiotics are used to prevent acute rheumatic fever, reduce symptom severity, and prevent transmission of the infection.
What is Lemierre syndrome, and who is at risk?
Lemierre syndrome is thrombophlebitis of the jugular vein, often associated with systemic inflammatory response syndrome (SIRS) or sepsis.
How can diphtheria be recognized, and what should be done if suspected
Diphtheria may present with grey/green oropharyngeal membranes and occurs in non-vaccinated individuals.
Throat swabs should be taken for culture to confirm the diagnosis.
What signs suggest that a sore throat may be a feature of primary HIV infection?
Sore throat in primary HIV infection may be accompanied by myalgia, arthralgia, lethargy, and a non-itchy maculopapular rash. Lymphadenopathy typically develops a week later.
What are some potential serious causes of sore throat that require hospital admission?
Epiglottitis, peri-tonsillar abscess (quinsy), Lemierre syndrome, Kawasaki disease, diphtheria, and any patient at high risk, such as the immunocompromised or very old.
How can measles be recognized in someone presenting with a sore throat?
Measles is suggested by conjunctivitis, rhinitis, cough, and a characteristic maculopapular rash, especially in non-vaccinated individuals. Koplik spots (bluish-white lesions on an erythematous base) may also be seen.
What is Kawasaki disease, and how can it present in children with a sore throat?
Kawasaki disease may present as a sore throat without exudate and includes symptoms like fever lasting 5+ days, conjunctivitis, changes in the lips and oral cavity, cervical lymphadenopathy, rash, and changes in the extremities. It primarily affects children under 4.
What is the FeverPAIN score, and how does it help in managing sore throat?
The FeverPAIN score helps assess the likelihood of Group A Streptococcus infection and guides the decision on whether to prescribe antibiotics.
What is the importance of safety netting and clinical judgement in the management of sore throat?
While decision tools help assess risk, clinical judgement is essential, particularly in recognizing red flags and serious conditions like sepsis. Safety netting ensures patients know when to seek further care if their condition worsens.
What are the red flags for sore throat that should prompt immediate action?
Stridor, breathing difficulties, signs of sepsis, suspected epiglottitis, or any suspicion of a serious underlying cause like diphtheria or Kawasaki disease.
