Sore Throat Flashcards
(46 cards)
Sore throats account for about ______of consultations
in general practice per annum
5%
MCC of sore throat
The common causes are viral pharyngitis
(approximately 60–65%) and tonsillitis due to
Streptococcus pyogenes (approximately 20%).
A very important cause is tonsillitis caused by
___________. Treating
this cause with penicillin can produce adverse
effects.
Epstein–Barr mononucleosis (EBM)
At least 50% of sore throats, mainly pharyngitis, will
be caused by a______
virus
It is vital to be aware of _______
infection in children, especially between 2 and 4 years,
when the deadly problem of epiglottitis can develop
suddenly
Haemophilus influenzae
There are many pitfalls, the classic being to diagnose
the exudative tonsillitis of EBM as _________and prescribe one of the penicillins, which
may precipitate a severe rash
streptococcal
tonsillitis
What are the red flags in sore throats
• Persistent high fever • Failed antibiotic treatment • Medication-induced agranulocytosis • Mouth drooling: consider epiglottitis (don’t examine the throat) • Sharp pain on swallowing (? foreign body) • Marked swelling of quinsy • Candidiasis: consider diabetes or immunosuppression
_______ are concretions of debris entrapped
within deep tonsillar crypts. They are a common
cause of halitosis, vague sore throat and possibly
recurrent bouts of tonsillitis
Tonsilloliths
Small patches of exudate on the palate or other
structure indicate________
Candida albicans (oral thrush)
A large whitish-yellow membrane virtually
covering both tonsils indicates _______
EBM
A generalised red, swollen appearance with
exudate indicates_______
GABHS infection
Throat swabs are about _____ effective in isolating
GABHS from the infected throat
90%
Swabs are seldom helpful because the isolation of
GABHS often represents ________
asymptomatic carriage
Generally, throat cultures are not necessary
except to verify the presence of _______ especially
in closed institutions such as boarding schools, or if
diphtheria is suspected in the non-immunised
S. pyogenes,
What is dxtc of GABHS
A positive culture and
a fourfold rise in the ASO titre are necessary for a
precise diagnosis.
What test should be done if suspicious for EBM
If suspected, an
IgM antibody test should be ordered, rather than the
older tests, such as a Paul–Bunnell test.
Analgesic for children
analgesia: adults—2 soluble aspirin; children— paracetamol elixir (not alcohol base) or ibuprofen
What age group to consider bacterial cause of sorethroat
A bacterial cause is more common in
children aged 3–13 years than in children <3 years
Sore throat in the elderly may be caused by a ________ but otherwise needs to be treated with considerable
respect
viral infection
painful swallowing + referred ear pain + hoarseness
pharyngeal cancer
This infection may involve the pharynx only and vary
from mild to severe, or it may involve both tonsils
and pharynx. It is uncommon under 3 years or over
40 years.
Streptococcal tonsillopharyngitis
Dxtic features of streptococcal throat
• constitutional symptoms: — fever ≥ 38°C — toxicity • tender anterior cervical lymphadenopathy • tonsillar swelling and exudate • absence of cough
Indications for antibiotic therapy in strep throat
• existing rheumatic heart disease at any age
• severe tonsillitis with above features of GABHS
scarlet fever
• peritonsillar cellulitis or abscess (quinsy)
• patients 2–25 years with presumptive GABHS
from special communities
INdication for abx in strep throat
If there is a sore throat with no cough, but
fever >38 ° C, tender neck glands and white spots
in the throat, antibiotics are indicated
