Case 2

A 23-year-old American woman has developed a sore throat whilst on holiday in the UK. She has had the problem for the 4 days and it is not easing. She is normally fit and well and doesn’t take any regular medication.

On examination, there are no signs of potential airway obstruction and no features of severe illness. She asks you whether you are going to do any tests to decide whether she has a ‘strep throat’ or another problem.

Select the most appropriate investigation for each of the conditions listed below.

You debate whether you should prescribe an antibiotic for this patient, particularly as she is planning to continue travelling around the UK for another week and has no access to primary care. Indicate which of the following factors are needed to determine the FeverPAIN score.

Select the five statements which are true.

Having performed a full history and examination of this 23-year- old patient with a sore throat for 4 days, you identify the following features:

• No history of cough
• Difficulty swallowing but able to swallow saliva
• Temperature 38.2^oC
• No rash present
• Tender anterior cervical lymphadenopathy
• Tonsils bilaterally severely swollen with exudate
• Petechiae on the palate
• Pharynx red but no exudate

Calculate the sore throat score and outline your management plan for this patient.