URTIs Flashcards
Features of acute otitis media
Earache +/- fever/systemic unwellness
O/E: red/yellow, bulging eardrum. May have discharge/perforations
Resolves spontaneous <=4d
Indications for tonsillectomy referral
Recurrent tonsillits: >=7/5/3 for 1/2/3 years
Otitis media indications for abx
Bilateral <2y
unilateral + otorrhea in children
Sore throat indications for antibiotics
FeverPAIN >=4
CENTOR >=2
Delayed abx if Feverpain >=2
Abx 1d less symptoms, small decrease in risk of complications
Antibiotic course in otitis media
5-7 days amoxicillin
Clarithromycin/erythromycin if pen-allergy
Antibiotic course in tonsilitis
Phenoxymethylpenicillin
Calirthromycin if allergic
3 days
Not amoxicillin - EBV rash
FeverPAIN score components
Fever in past 24h
Symptoms <=3d
No cough
Purulent tonsils
Severe tonsil inflammation
CENTOR criteria
Can’t cough
Exudate
Nodes
Temp >=38
Less useful <3 or >45
Differential for sore throat
Influenza - headache, myalgia, dry cough,
Infectious mononucleosis - ELISPOT, FBC, several days, lymph nodes, splenomagaly
Herpetic pharyngitis - vesicles in palate, gums, buccal mucosa
Serious complications of sore throat req hospital admission
Peritonsillar abscess - trsimsus, difficulty swallowing, unilateral tonsillar swelling
Retropharyngeal asbcess - difficulty swallowing
Rheumatic fever
Epiglottitis
Safety-ntting sore throat in primary care
Symptoms not improving within 3-4 days
Difficulty breathing or unilateral throat/neck swelling
Criteria for admission in acute otitis media
Complications - meningitis, mastoiditis, intracranial abscess, FN palsy, sinus thrombosis
<3mo + fever >38
severe systemic illness
Definition of recurrent otitis media
>=3 in 6 mo or >=4 in 12mo
Warning signs for 2ww referral to ENT
Epistaxis/nasal obstruction
Persistent OME/symptoms between recurrent OM
Cervical lymphadenopathy persistent
