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SORE THROAT

SORE THROAT. Most people don't need antibiotics!. 85% get better in a week. CAUSES. Viruses 20% (rhino/adeno/parainfluenza) Bacteria 17% (GABHS) Thrush (post Abx/immunosupressants) Chemical irritation (inhaler technique) Allergy (dust) Smoking (chronic sore throat) Cancer TB

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SORE THROAT

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  1. SORE THROAT

  2. Most people don't need antibiotics! 85% get better in a week

  3. CAUSES • Viruses 20% (rhino/adeno/parainfluenza) • Bacteria 17% (GABHS) • Thrush (post Abx/immunosupressants) • Chemical irritation (inhaler technique) • Allergy (dust) • Smoking (chronic sore throat) • Cancer • TB • Tonsillitis • Glandular Fever ….which is the most common cause?

  4. FEVER Tender anterior cervical nodes Tonsilar exudates No cough CENTOR Criteria Higher risk GABHS If 3/4 + unwell = 1:60 risk quinsy (1:400 if well)

  5. Treatment • Stall them! See if it goes away: • Paracetamol gargle/Ibuprofen • Difflam • Lozenges • Penicillin V 500mg qds 10days • Delayed scripts • More likely to reattend if given Abx • Tonsillectomy if >3/y, >5/2y

  6. Glandular Fever • 98% sore throat, lymphadenopathy, fever + tonsillar enlargement • Self Limiting (rest, fluids, antipyretics) • Don’t give Amox as risk rash • Older people more likely to get hepatomegaly + jaundice

  7. Pretty geeky song… I heard there’s sore throat going round That brings most people to the ground But actually, it’s just tonsillitis… It starts with pain and fever too Anterior lymph node tenderness And all the stuff in Centor’s criteria… And you look inside and see the pus It’s sore and it’s red And then you say, my god, you got tonsillitis… My poor sore throat Could be tonsillitis Or glandular fever Or just a virus My poor sore throat Needs penicillin…

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