Throat

Question 1

What is the commonest cause of tonsillitis?

Answer 1

Epstein-Barr Virus

Question 2

What is the commonest bacterial cause of tonsillitis?

Answer 2

Streptococcus Pyogenes

Question 3

What is the commonest cause of recurrent tonsillitis?

Answer 3

Streptococcus pyogenes

Question 4

How does tonsillitis present?

Answer 4

Sore throat
Painful swallowing
Fever

Question 5

How is tonsillitis diagnosed?

Answer 5

Centor criteria

Question 6

What is the centor criteria for tonsillitis?

Answer 6

Fever >380C
Tonsillar exudates- white patches on tonsils
Absence of cough
Tender anterior cervical lymph nodes

Question 7

What is the management of viral tonsillitis?

Answer 7

Analgesia- Paracetamol or Ibuprofen

Question 8

What is the management of bacterial tonsillitis?

Answer 8

Penicillin V (phenoxymethylpenicillin)

Question 9

What is the surgical management of tonsillitis?

Answer 9

Tonsillectomy

Question 10

What are the complications of tonsillitis?

Answer 10

Quinsy-peritonsillar abscess

Question 11

What is another name for croup?

Answer 11

Laryngotracheobronchitis

Question 12

What is croup?

Answer 12

A form of upper respiratory tract infection

Question 13

Who is croup seen in?

Answer 13

6months to 3 years

Question 14

What is the main cause of croup?

Answer 14

Parainfluenza virus

Question 15

What is the presentation of croup?

Answer 15

Stridor
Barking cough (worse at night)
Fever
Coryzal symptoms

Question 16

How is croup diagnosed?

Answer 16

Clinical diagnosis

Question 17

What is seen on a chest x-ray?

Answer 17

Subglottic narrowing-‘steeple sign’

Swelling of the epiglottis - the ‘thumb sign’

Question 18

What is the management of croup?

Answer 18

A single dose of oral dexamethasone to all children

Question 19

What is an alternative to dexamethasone?

Answer 19

Prednisolone

Question 20

What is the emergency management of croup?

Answer 20

High flow oxygen

Nebulised adrenaline

Question 21

What is a thyroglossal cyst?

Answer 21

A thyroglossal duct persists and becomes a fluid filled cyst

Question 22

What is a complication of a thyroglossal cyst?

Answer 22

The cyst becomes infected causing a hot painful lump

Question 23

What are the features of a thyroglossal cyst?

Answer 23

In the midline of the neck
Mobile, non-tender lump
Painful if infected

Question 24

What happens to the cyst with protrusion of the tongue?

Answer 24

The cyst moves up and down

Question 25

How is a thyroglossal cyst diagnosed?

Answer 25

Ultrasound

Question 26

What is the management of a thyroglossal cyst?

Answer 26

Surgical removal and histology

Question 27

What is epiglottitis?

Answer 27

Infection causing inflammation of the epiglottis?

Question 28

What is the main cause of epiglottitis?

Answer 28

Haemophilus influenza B

Question 29

What is the presentation of epiglottitis?

Answer 29

``` Rapid onset High temperature Generally unwell Stridor Drooling of saliva ```

Question 30

What makes breathing easier in epiglottitis?

Answer 30

Easier to breathe if patient leaning forward and extending neck in a seated position

Question 31

How is epiglottitis diagnosed?

Answer 31

Direct visualistion

Question 32

What might be seen on a chest x-ray of epiglottitis?

Answer 32

Subglottic narrowing-'steeple sign' | Swelling of the epiglottis - the 'thumb sign'

Question 33

What should you not do in suspected epiglottitis?

Answer 33

Examine the throat due to the risk of acute airway obstruction

Question 34

What is the needed to protect the airway in epiglottitis?

Answer 34

Endotracheal intubation

Question 35

What is the management of epiglottitis?

Answer 35

Oxygen | Intravenous antibiotics- Cefuroxime