Hello, med students.

My name is Zach Olson, and thank you for downloading this episode of the EM Clerkship Podcast.

Today we are going to talk about sore throat.

Because I remember on my med school emergency medicine rotation, there were lots of these cases in the department,

obviously. They always had strep or man flu or something. But every single time, my attendings

would give me the same pimp question when I had a patient with sore throat. And they would go,

give me four life-threatening, worst-case scenario causes for sore throat.

And so we're going to go through those today. But before we discuss those four causes, though,

real quick, let's go through an approach, as always. Step one, apply the centaur criteria.

What are the centaur criteria?

It's a list of four things that determine your risk for having group A strep.

The classic strep throat.

These four things are fever, no cough, enlarged lymph nodes, and exudate on the tonsils.

Fever, no cough, enlarged nodes, tonsular exudates.

If the patient has all four of these, then you can give them antibiotics

or strep. That way they don't get rheumatic fever. If they only have a couple of these,

you only treat their strep if their strep swabs are positive. And if they don't have any of

these or just like maybe one of them, you don't give them antibiotics. You don't test them.

Those four center criteria are fever, no cough, enlarged nodes, and exudate on the tonsils.

Center criteria, they're called. Step two, antibiotics. Let's say they do meet all the center criteria, they're called. Step two, antibiotics.

Let's say they do meet all the center criteria or they had a positive throat swab.

Which antibiotic do you use?

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