Tonsilitis

Question 1

What are viral causes

Answer 1

rhinovirus
adenovirus
RSV

Question 2

What are bacteria causes

Answer 2

Group A streptococcus

Question 3

What may someone with viral tonsillitis present with

Answer 3

low grade fever
cough
rhinorrhoea

Question 4

What may someone with bacterial tonsillitis present with

Answer 4

high grade fever
sore throat
odynophagia
dysphagia

Question 5

What scoring systems are used to determine severity

Answer 5

Fever PAIN

CENTOR

Question 6

What is the criteria for Fever PAIN

Answer 6

1 point each

Fever last 24hrs
Pus
attends rapidly <3 days
Inflamed tonsils
No cough or coryza

Question 7

What is the criteria for CENTOR

Answer 7

1 point each

Cant cough
Exudate
Nodes
Temperature >38

OR age <15 +1 OR age >44 -1

Question 8

What investigations are required

Answer 8

if high risk of rheumatic fever, very old/young or immunocompromised/severe symptoms

Rapid antigen A Strep test - RAST

culture if that is negative

Question 9

When do you give immediate antibiotics

Answer 9

If Fever PAIN 4-5 or CENTOR 3-4

PHENOXYMETHYLPENICILLIN

if allergic
clarithromycin or erythromycin

Question 10

What are complications of tonisillitis

Answer 10

otitis media

quinsy - peritonsillar abscess

rheumatic fever and glomerulonephritis very rarely

Question 11

When should surgery be considered

Answer 11

all of this criteria met

• sore throats due to tonsillitis
• 5 or more episodes of sore throat per year
• symptoms for at least a year
• episodes are disabling and prevent normal function