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Flashcards in Sore Throat Deck (21)
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1
Q

What is the difference between a sore throat and odynophagia?

A

A sore throat is a pain in the throat that worsens with swallowing. Odynophagia is a main that only occurs whilst swallowing

2
Q

What are the main differential diagnoses of a sore throat?

A
  • Viral pharyngitis
  • Acute follicular tonsillitis
  • Infectious mononucleosis (glandular fever)
  • Candidiasis of buccal or oesophageal mucosa
  • Agranulocytosis
3
Q

What suggests that viral pharyngitis is the cause of sore throat?

A
  • Pain on swallowing
  • Fever
  • Cervical lymphadenopathy
  • Increased lymphocytes
  • Normal or decreased leucocytes
4
Q

What confirms that viral pharyngitis is the cause of a sore throat?

A
  • Negative throat swab for bacterial culture
  • Resolution within days
5
Q

How is viral pharyngitis managed?

A
  • Lozenges
  • Paracetamol
6
Q

What suggests that acute follicular tonsillitis is the cause of sore throat?

A
  • Severe sore throat
  • Pain on swallowing
  • Fever
  • Enlarged tonsils with white patches
  • Cervical lymphadenopathy, especially in angle of jaw
  • Increased leucocytes
7
Q

What confirms that acute follicular tonsillitis is the cause of sore throat?

A

Positive throat swab for bacteria

8
Q

How is acute follicular tonsillitis managed?

A
  • Analgesic
  • Antibiotics, e.g. penicillin, cephalosporin, or co-amoxiclav
9
Q

What virus causes infectious mononucleosis?

A

Epstein-Barr

10
Q

What suggests that infectious mononucleosis is the cause of sore throat?

A
  • Very severe throat pain
  • Enlarged tonsils covered in grey mucoid film
  • Generalised lymphadenopathy
  • Hepatomegaly
  • Splenomegaly
11
Q

What confirms that infectious mononucleosis is the cause of a sore throat?

A
  • Increased atypical lymphocytes
  • Paul-Bunnell or Monospot test result positive
  • Viral titres
12
Q

How is infectious mononucleosis managed?

A
  • Lozenges
  • Analgesics, e.g. paracetamol
13
Q

What might happen if you give aspirin to a patient with infectious mononucleosis?

A

Reye’s syndrome

14
Q

What suggests that candidiasis of the buccal or oesophageal mucosa is the cause of sore throat?

A
  • Painful dysphagia
  • White plaques
  • History of immunosuppression, diabetes, or recent antibiotics
15
Q

How is it confirmed that candidiasis or the buccal or oesophageal mucosa is the cause of sore throat?

A
  • Oesophagoscopy showing erythema and plaques
  • Brush cytology, with or without biopsy, showing spores and hyphae
16
Q

How is candidasis of buccal or oesophagela mucosa managed?

A
  • Analgesics
  • Antifungal lozenges or solutions, e.g. nystatin, fluconazole
17
Q

Give an example of something that might cause agranulocytosis

A

Antithyroid drugs

18
Q

What suggests that agranulocytosis is the cause of sore throat?

A
  • History of taking a drug that can cause, e.g. carbimazole
  • Contact with noxious substance
19
Q

What confirms that agranulocytosis is the cause of sore throat?

A

Low or absent neutrophil count

20
Q

How is agranulocytosis managed?

A
  • Remove cause
  • Broad spectrum antibiotic IV or PO if febrile
21
Q

What can cause sore throat with oropharyngeal ulceration?

A
  • Herpes zoster infection
  • Herpes simplex infection
  • Local herpangina
  • Aphtous ulceration