What distinguishes a sore throat from strep?

Medical test: For significant sore throat with swollen tonsils / lymph nodes – see physician & get a strep throat test. If you have streph throat, antibiotic therapy is imperative to prevent future compications. Sxs of strep throat can include: large, red painful tonsils with white exudates; small red dots on the roof of the mouth; swollen lymph nodes on the neck; fever, headache, rash & difficulty swallowing.