QuestionSBA
QuestionChoice
This patient is acutely unwell, a referral is very unlikely to happen in time to help. Therefore, an urgent hospital admission is needed to assess for and treat acute epiglottitis.
10027860
e
Refer to Respiratory
QuestionChoice
This would be an appropriate management for tonsilitis. However, this patient would score only a two on the feverPAIN score. This would be for her fever and absent cough. The fact the tonsils are not inflamed or covered by exudate makes tonsilitis less likely.
10027858
c
Prescribe phenoxymethylpenicillin
QuestionChoice
This patient is having difficulty breathing and experiencing stridor which both suggest inflammation causing an airway obstruction. Therefore, urgent hospital admission is necessary.
10027857
b
Encourage oral fluids and analgesia with safety netting advice
QuestionChoice
This patient has some red flag features of epiglottitis which requires urgent hospital admission. The fact she has developed stridor, drooling and difficulty breathing are key indicators of this condition.
10027856
a
Ring for an ambulance
QuestionChoice
This would be an appropriate management for tonsilitis, in this case, the patient is scoring 2 on the feverPAIN score so a backup antibiotic prescription is indicated. However, the child is more acutely unwell with epiglottitis so needs to be urgently assessed at the hospital.
10027859
d
Prescribe a backup course of phenoxymethylpenicillin
Concept
Chapter
2693
6010
Stridor
Topic
138
Ear, Nose & Throat
17969
A mother brings her two-year-old daughter to a GP appointment. She tells you that her child has been unwell for four days with a fever and is generally irritable. This morning, she noticed her daughter was making a high-pitched noise as she was breathing in. On examination, the child looks unwell and has a temperature of 38.0. You notice she is drooling as well as having some difficulty breathing. On inspection of the oral cavity, the tonsils are not inflamed or covered in exudate.

Given the likely diagnosis, what is the most appropriate management?
a