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Flashcards in Adenotonsillar Disease Deck (26)
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1
Q

Between what ages do the tonsils usually develop fully?

A

2-10 yrs

2
Q

State the main function of the tonsils

A

Trap inhaled bacteria + viruses and present to immune system

3
Q

What is Waldeyer’s ring?

A

Ring of MALT between the oropharynx and nasopharynx

Comprises tonsils, adenoids + lingual tonsils

4
Q

How does the histology of the tonsils differ from that of the adenoids?

A

Tonsils: specialised squamous, crypts
Adenoids: resp epithelium, folds, transitional

5
Q

Acute tonsillitis is usually bacterial. True/False?

A

False

Usually viral

6
Q

List the main viruses that cause acute tonsillitis

A
EBV
Influenza
Rhinovirus
Enterovirus
Adenovirus
7
Q

What is the most commonest bacterial cause of acute tonsillitis?

A

Group A Strep.

8
Q

Throat swabs are not recommended in acute tonsillitis. Why?

A

Surface bacteria do not always reflect core species

9
Q

List symptoms of acute viral tonsillitis

A
Malaise
Sore throat
Temperature
Able to do daily tasks
Mainly self-limiting: lasts 3-4 days
10
Q

List symptoms of acute bacterial tonsillitis

A
Systemic upset
Fever
Odynophagia
Halitosis
Unable to work/school
Lasts 1 week +
11
Q

Which criteria helps differentiate between viral and bacterial tonsillitis?

A

Centor Criteria

12
Q

How many points on the Centor Criteria warrants antibiotic use for acute tonsillitis?

A

2 or 3 points if progressing

4 or 5 points = treat empirically

13
Q

Outline conservative management for acute tonsillitis

A

Bed rest
Fluids
Analgesia (paracetamol, NSAID)

14
Q

Which antibiotics can be given for acute tonsillitis?

A

Penicillin for 10 days

Clarithromycin if pen-allergic

15
Q

Surgery (tonsillectomy) is often done for tonsillitis. True/False?

A

False

Not as often as it used to be

16
Q

List indications for tonsillectomy

A

Recurrent severe tonsillitis
Well-documented visits to practice for tonsillitis
Numerous episodes in 2-3 years

17
Q

The risk of mortality from tonsillitis is less than the risk of complications of tonsillectomy. True/False?

A

True

18
Q

What is peritonsillar abscess?

A

Complication of tonsillitis where infection moves to space between tonsil and muscle

19
Q

What is the classic history/presentation of peritonsillar abscess?

A

Tonsillitis improving but developing unilateral throat pain and odynophagia
Medial displacement of tonsil + uvula contralaterally

20
Q

How is peritonsillar abscess treated?

A

Aspiration

Antibiotics (penicillin)

21
Q

What is glandular fever?

A

Infectious mononucleosis caused by EBV

22
Q

List signs and symptoms of glandular fever

A

Feeling washed out
Malaise
Gross tonsillar enlargement with membranous exudate
Lymphadenopathy

23
Q

How is glandular fever diagnosed?

A

+ve Monospot or Paul-Bunnell test

24
Q

CRP is very high in glandular fever. True/False?

A

False

Usually below 100

25
Q

What is the antibiotic of choice for glandular fever?

A

Penicillin

26
Q

Do not prescribe amoxicillin for tonsillitis or glandular fever. True/False?

A

True