Sore throat

Question 1

Centor criteria for sore throat?

Answer 1

• Presence of tonsillar exudate
• Tender anterior cervical lymphadenopathy
• History of fever
• Absence of cough

Question 2

FeverPAIN criteria for sore throat?

Answer 2

• Fever > 38deg
• Purulence
• Attend rapidly (<3 days)
• Inflamed tonsils
• No cough or coryza

Question 3

NICE indications for antibiotics…

Answer 3

• Systemic upset secondary to acute sore throat
• Unilateral peritonsilitis
• History of rheumatic fever
• Increased risk from acute infection - immunodeficient
• Centor score > 3

Question 4

What is the first line antibiotic used in sore throat?

Answer 4

Phenoxymethypenicillin: 7-10 day course

Question 5

What are the classical features of glandular fever (infectious mononucleosis)?

Answer 5

1. Sore throat
2. Lymphadenopathy - present in anterior and posterior triangles of the neck
3. Pyrexia

Question 6

What are the other features of glandular fever?

Answer 6

• palatal petechiae
• splenomegaly
• hepatitis
• lymphocytosis

Question 7

What happens when someone takes amoxicillin whilst having glandular fever?

Answer 7

Maculopapular, priuritic rash develops in around 99% of patients

Question 8

Main differences between IgA nephropathy and Post-strep glomerulonephritis…

Answer 8

IgA nephorpathy:
- Mostly young men
- 1-2 days after URTI

Post strep glomerulonephritis:
- Mostly young children
- 1-2 weeks after URTI

Question 9

Why are people told to avoid contact sports until 4 weeks after having glandular fever?

Answer 9

Splenomegaly puts people at risk of splenic rupture.

Question 10

What is the causative organism in scarlet fever?

Answer 10

Group A haemolytic stroptococci (Streptococcus pyogenes)

Question 11

What are the main features of scarlet fever?

Answer 11

• Fever
• Malaise, headache
• Sore throat
• Strawberry tongue
• Rash (fine punctate erythema - generally appears on the torso first)

Question 12

What is the treatment for scarlet fever?

Answer 12

1st line = Penicillin V for 10 days
Pen allergy = Azithromycin
Children can return to school 24 hours after starting abx

Question 13

What are the indications for tonsillectomy?

Answer 13

1. ALL of the following criteria need to be met:
   - Sore throats are due to tonsillitis
   - >5 episodes of tonsillitis in one year
   - Has been occurring for more than one year
   - The episodes of sore throat are severe and disabling

OR

2. Febrile convulsions secondary to sore throat
3. Obstructive sleep apnoea
4. Peritonsillar abscess

Question 14

Most common complication of tonsillectomy?

Answer 14

Haemorrhage - initially secondary to inadequate haemostasis, otherwise secondary to infection