QuestionSBA
QuestionChoice
Flucloxacillin is a narrow-spectrum penicillin antibiotic that is most commonly used to treat skin and soft tissue infections. It is not used in the treatment of streptococcal tonsillitis
33969
e
Flucloxacillin 500mg PO QDS
QuestionChoice
While benzylpenicillin has activity against susceptible Gram-positive streptococci, an intravenous antibiotic would not be appropriate to treat likely uncomplicated streptococcal tonsillitis
33968
d
Benzylpenicillin sodium 900mg IV TDS
QuestionChoice
Co-amoxiclav is a safer option than amoxicillin alone as it has a lower risk of morbilliform drug eruption in the event of misdiagnosed infectious mononucleosis. However it has a much broader spectrum of activity which may not be necessary to treat likely uncomplicated streptococcal tonsillitis
33966
b
Co-amoxiclav 625mg PO TDS
QuestionChoice
Amoxicillin should not be given alone to treat suspected streptococcal tonsillitis due to the risk of misdiagnosed infectious mononucleosis and morbilliform drug eruption
33967
c
Amoxicillin 500mg PO TDS
QuestionChoice
Phenoxymethylpenicillin is recommended first line to treat streptococcal tonsillitis in all age groups. Clarithromycin is an acceptable alternative option in penicillin-allergic patients
33965
a
Phenoxymethylpenicillin 500mg PO QDS
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2737
1st line treatment for streptococcal tonsillitis - penicillin V
Topic
9
Internal Medicine
6804
Case Presentation: A 12 year old boy is brought by his parents into a walk-in clinic with fever, throat pain and malaise. He has had these symptoms for the past 48 hours. **PH** asthma. **DH** salbutamol 200 micrograms inhaler PRN. NKDA


**O/E**

HR 110, RR 16, BP 110/75, Temperature 38.4°C, O2 100% RA. Alert and oriented. Bilaterally enlarged tonsils with patchy exudates. Swollen submandibular and anterior cervical lymph nodes.

Question: Select the most appropriate management at this stage.
a