Sore Throat Blogs This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Letter to my patient
These 'letters' were passed to me by colleagues. I guess I work with alot of...frustrated docs. (these were not written by me)Dear Patient:You came in at 11pm last night with a chief complaint of sore throat while munching on a sandwich at triage. Next time you choose a sandwich to bring with you to the ED, try something that will go down easier. Peanut butter and Jelly – while I’m sure was very tasty, made my ENT exam, well… a bit difficult. But alas, we did get through it and I got to see your very normal throat. While I was tempted to leave the diagnosis of “no real complaint” on your chart, after envisioning ...
Source: EM Physician - Backstage Pass - September 8, 2015 Category: Emergency Medicine Authors: Taylor Source Type: blogs

Test your medicine knowledge: 84-year-old man with cough and nasal congestion
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. An 84-year-old man is evaluated for a 5-day history of rhinitis, nasal congestion, sneezing, and nonproductive cough. The symptoms began with a sore throat, which resolved after 24 hours. He has mild ear pain when blowing his nose or coughing. He has a history of coronary artery disease and hypertension. Medications are aspirin, metoprolol, and hydrochlorothiazide. On physical examination, temperature is 36.5 °C (97.7 °F), blood pressure is 130/72 mm Hg, pulse rate is 82/min, and respiration rate is 16/min. He...
Source: Kevin, M.D. - Medical Weblog - September 5, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Primary care Source Type: blogs

A young healthy male with epigastric pain and tachycardia
A young previously healthy man with no past medical history presented with a complaint of epigastric pain for a few days. He had no other complaints. He appeared well. Vitals were HR 107, BP 140/70, sats 98%, RR 20, Temp 36.7. He had a normal exam except for the mild tachycardia.The physician was planning on discharging the patient except for the tachycardia, which prompted him to obtain an ECG. He was startled by the result. He showed it to me:QRS 105 ms. Sinus tach. RV conduction delay (R'-wave in V1)Diffuse ST depression, diagnostic of ischemia.Not knowing anything else about t...
Source: Dr. Smith's ECG Blog - August 14, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

10 things you might not know about the emergency department
1. Wait times in most emergency departments are ridiculous. But, if you have a real emergency, you won’t have to wait. If you have abnormal vital signs, a worrisome ECG, or concerning chief complaint, you will be seen long before the person who checked in with a sore throat to get a work excuse. Patients with chief complaints like “GSW abdomen” and “found down/unresponsive” don’t wait to be seen. And if the day ever comes (God forbid) that you have one of those problems, you won’t either. (Insider tip for non-emergencies: show up around 6 a.m. on a Sunday morning and you probably won’t have to wa...
Source: Kevin, M.D. - Medical Weblog - July 22, 2015 Category: Journals (General) Authors: Kristin Prentiss Ott, MD Tags: Physician Emergency Source Type: blogs

How to teach clinical medicine – lessons learned by studying sore throats for 35 years
35 years ago I started collecting data in a non-acute emergency room. Over approximately 3 months the residents enrolled slightly more than 300 patients into the initial sore throat study. Spending the next 3 months learning how to analyze the data, I began a long journey that continues today. Learning medicine rarely includes having epiphanies. Learning medicine requires patients and reading. But we who teach medicine can help our learners speed that process if we help them focus on some key features. My colleagues and I often cite Judy Bowen’s classic article – Bowen, Judith L. “Educational strat...
Source: DB's Medical Rants - June 4, 2015 Category: Internal Medicine Authors: rcentor Tags: Attending Rounds Medical Rants Source Type: blogs

The problems with a low salt diet
One of my favorite physician sayings is, “Don’t just do something, stand there!” Which means that it’s better to do nothing than to do something that doesn’t help. As I move through my career, I find myself agreeing. I am endlessly amazed at the number of things we do for no good reason, and that patients come to expect, also for no good reason. For instance, we believe that every earache and sore throat needs an antibiotic, when it’s clearly not the case. We always give antibiotics for seven to ten days, but without knowing why we picked those durations (other than the fact that they were easy to remem...
Source: Kevin, M.D. - Medical Weblog - June 3, 2015 Category: Journals (General) Authors: Edwin Leap, MD Tags: Conditions Heart Source Type: blogs

How to Prevent and Treat Tonsil Stones
When I was a child, it was commonplace to remove tonsils. The thinking of the day was that tonsils didn’t serve much of a purpose. Much like the thinking of the day about the appendix. Now we know the tonsils serve as filters keeping bacteria, viruses, and foreign bodies that enter the mouth from making their way into the digestive system. When they do their jobs well, the trapped bacteria or viruses can cause a great deal of discomfort. In that regard, a sore throat is a sign that the tonsils are doing their job. For some people, especially adolescents, the tonsils can trap “mouth debris” (isn’t th...
Source: Conversations with Dr Greene - May 18, 2015 Category: Child Development Authors: Dr. Alan Greene Tags: Dr. Greene's Blog Diseases & Conditions Tonsils Source Type: blogs

Why does sore throat diagnosis and management cause controversy?
In 2007, Malcolm Gladwell spoke to the Society of Medical Decision Making in Pittsburgh. In his talk concerning decision making, he used sore throats as an example of “easy decision making”. Of course I stood up after his talk to point out that even sore throats raise complex decisions. Just this year, my friend and colleague Jeffrey Linder titled his editorial about our recent pharyngitis paper: Sore Throat: Avoid Overcomplicating the Uncomplicated Sore throats often are uncomplicated. They often represent “just a sore throat”. But sometimes they portend more serious illness. Many diagnostic de...
Source: DB's Medical Rants - April 10, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

We should do a better job teaching “red flags”
Over the years, I have written about the short head and long tail. You can use the search function to find several posts since then. For those who have not considered the long tail, it refers to the approximately 15-20% of patients who are not routine. For each chief complaint, some patients will not have one of the “usual suspect” diagnoses. Our job is to recognize when we need to think of more usual diagnoses. Experts can tell you what “red flags” lead them to slow down. I did an interview that will likely appear on television (I will link the piece when it becomes available). The interviewer aske...
Source: DB's Medical Rants - March 5, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Antibiotic resistance – should we blame primary care or ICU physicians?
The title of the post poses a somewhat silly question. But I hope my explication clarifies the point. Many readers know that I favor empiric antibiotic treatment for adolescent/young adult pharyngitis when the clinical signs and symptoms strongly suggest a bacterial infection. I favor narrow target antibiotics and only in the patients with Centor scores of 3 or 4 (and perhaps some 2s when the patient looks very ill). This would exclude over 50% of patients from antibiotics. Most organisms already have developed resistance to penicillin, amoxicillin and first generation cephalosporins. Macrolides should not be used for ...
Source: DB's Medical Rants - March 3, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Interpreting the new sore throat article
First, this study required the work of a large team. The main work happened in two places – a research microbiology laboratory and our college health clinic. They took an idea and translated it into an opportunity to collect and analyze data. Second, the accompanying editorial (written by a friend and excellent researcher Dr. Jeffrey Linder) raises some questions that I will work to answer. He writes that we do not have enough evidence to change practice yet. He postulates that Fusobacterium necrophorum might not actually cause pharyngitis and that linking positive PCR testing to the risk of suppurative complicat...
Source: DB's Medical Rants - February 23, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

A tale of two strep throats: Retail clinic vs. PCP
Six years ago, just after arriving in Baltimore for a winter conference, I fell sick with fever and a bad sore throat. After a night of feeling awful, I went looking for help. I found it at a Minute Clinic in a CVS near the hotel. I was seen right away by a friendly NP, who did a rapid strep test and prescribed me medication. I picked up my medication at the pharmacy there. The visit cost something like $85 and took maybe 30 minutes. They gave me forms to submit to my California insurance. And I was well enough to present my research as planned by day 3 of the conference. Continue reading ... Your patients are rating you ...
Source: Kevin, M.D. - Medical Weblog - February 21, 2015 Category: Journals (General) Authors: Leslie Kernisan, MD, MPH Tags: Conditions Infectious disease Primary care Source Type: blogs

Does Tamiflu work and what are the side effects?
The flu season has really gotten into gear now with 46 of our 50 states reporting widespread influenza activity as of January 3, 2015. Influenza is a virus that infects the respiratory tract, causing sore throat, runny nose, fever, and cough. Rarely people with the flu will have nausea, vomiting and diarrhea, but this is not “stomach flu” which is a term some of us use to describe any one of a number of viruses that give us intestinal symptoms. Influenza is the one where you hurt all over, you have a high fever and cold symptoms, then you start coughing and you can barely get out of bed for days. Sometimes it&#...
Source: Kevin, M.D. - Medical Weblog - February 20, 2015 Category: Journals (General) Authors: Janice Boughton, MD Tags: Meds Infectious disease Source Type: blogs