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CAUSES
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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?
Treatment
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Stall them! See if it goes away:
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Paracetamol gargle/Ibuprofen
Difflam
Lozenges
Penicillin V 500mg qds 10days
 Delayed scripts
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More likely to reattend if given Abx
 Tonsillectomy if >3/y, >5/2y
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Glandular Fever
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98% sore throat, lymphadenopathy, fever +
tonsillar enlargement
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Self Limiting (rest, fluids, antipyretics)
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Don’t give Amox as risk rash
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Older people more likely to get hepatomegaly +
jaundice
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…