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Recurrent Tonsillitis — UKMLA MCQ

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HardENTRecurrent TonsillitisUKMLAMRCEM SBAMRCP Part 1

Six days after tonsillectomy, a patient presents after vomiting fresh blood. There is no active bleeding on arrival, but pulse is 112/min and the tonsillar fossae contain clot. What is the safest management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Resuscitate, keep nil by mouth and obtain urgent ENT assessment in hospital

B is correct because secondary post-tonsillectomy haemorrhage may recur catastrophically; tachycardia and clot require resuscitation, fasting, hospital observation and urgent ENT review. A can dislodge tamponade and provoke bleeding. C underestimates the haemorrhagic risk. D may be an adjunct but cannot replace observation and specialist control. E risks renewed bleeding and aspiration.

Reference: NHS Getting It Right First Time, adult tonsillectomy pathway: https://gettingitrightfirsttime.co.uk/wp-content/uploads/2025/04/Adult-Tonsillectomy-pathway-April-2025-FINAL.pdf