INESSS Pharyngitis-tonsillitis

Question 1

Name signs of pharyngitis-tonsillitis GAS infection (6)

Answer 1

1- Tender anterior cervical adenopathy
2- Fever
3- Tonsillar exudates
4- Pain on swallowing
5- Severe sore throat
6- Tonsils ans pharynx inflammation

Question 2

What key indicator in history would increase risk of GAS?

Answer 2

Proven contact in the past two weeks.

Question 3

What is the name of the tool to assess infection risk of GAS and how do you use it?

Answer 3

Centor score.
1 point for each criterea. (0 points if 15 to 44 and -1 point if over 45yo)
0 to 2: Not suggestive of GAS. No testing required.
3 to 5: Suggestive of GAS pharyngitis-tonsillitis. Testing required.

Question 4

In what cases will you start treatment for GAS pharyngitis-tonsillitis without waiting for culture result or without a Rapid strep test? (4)

Answer 4

1- Very severe symptoms
2- Clinical signs of scarlatina (rash)
3- Complications from their pharyngitis-tonsillitis
4- Hx of acute rheumatic fever

Question 5

1st choice ATB therapy for children and adults. (Pharyngitis and tonsillitis)

Answer 5

1- Children: Penicillin V 50mg/kg/day PO divided BID x 10 days.
2- Adult: Penicillin V 600mg PO BID x 10 days.

Question 6

Counselling for pharyngitis-tonsillitis (3)

Answer 6

1- Child can return to school after 24hrs treatment
2- RTC if no response observed after 48-72hrs of treatment
3- Reduce pain and fever with Acetaminophen or ibuprofen