TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 83: Pharyngitis and Tonsillitis Buttaro: Primary Care: A Collaborative Practice, 6th Edition MULTIPLE CHOICE 1. A patient reports a sudden onset of sore throat, fever, malaise, and cough. The provider notes mild erythema of the pharynx and clear rhinorrhea without cervical lymphadenopathy. What is the most likely cause of these symptoms? a. Allergic pharyngitis b. Group A streptococcus c. Infectious mononucleosis d. Viral pharyngitis ANS: D Viral pharyngitis will cause sore throat, fever, and malaise and is often accompanied by URI symptoms of cough and runny nose. Allergic pharyngitis usually also causes dryness. GAS causes high fever, cervical adenopathy, and marked erythema with exudate. Infectious mononucleosis will cause an exudate along with cervical adenopathy. 2. A patient presents with sore throat, a temperature of 38.5°C, tonsillar exudates, and cervical lymphadenopathy. What will the provider do next to manage this patient’s symptoms? a. Order an anti-streptolysin O (ASO) titer. b. Perform a rapid antigen detection test (RADT). c. Prescribe empirical penicillin. d. Refer to an otolaryngologist.
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ANS: B The RADT is performed initially to determine whether Group A -hemolytic Streptococcus (GAS) is present. The ASO titer is not used during initial diagnostic screening. Penicillin should not be given empirically. A referral to a specialist is not required for GAS infection. 3. A school-age child has had 5 episodes of tonsillitis in the past year and 2 episodes the previous year. The child’s parent asks the provider if the child needs a tonsillectomy. What will the provider tell this parent? a. Current recommendations do not support tonsillectomy for this child. b. If there is one more episode in the next 6 months, a tonsillectomy is necessary. c. The child should have radiographic studies to evaluate the need for tonsillectomy. d. Tonsillectomy is recommended based on this child’s history. ANS: A Management of chronic pharyngitis or tonsillitis with GAS infection may require tonsillectomy. Tonsillectomy is not performed as often as in the past due to retrospective studies that suggest there is little benefit and a chance of significant postsurgical complications. Radiographic studies are not indicated.
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