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A - MSRA ENT [6] > [18] Tonsillitis > Flashcards

[18] Tonsillitis Flashcards

1
Q

What is tonsillitis?

A

Inflammation of the tonsils

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2
Q

What are the tonsils?

A

Collections of lymphoid tissue facing into the aerodigestive tract

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3
Q

What is Waldeyer’s ring?

A

A set of lymphatic tissues (tonsils)

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4
Q

What does Waldeyer’s ring consist of?

A
  • Adenoid tonsils
  • Tubal tonsils
  • Palatine tonsils
  • Lingual tonsil
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5
Q

What is the most common cause of tonsillitis?

A

Viral infection

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6
Q

What are the viral causes of tonsillitis?

A
  • Adenovirus
  • Rhinovirus
  • Influenza
  • Coronavirus
  • RSV
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7
Q

What is the second most common cause of tonsillitis?

A

Bacterial infection

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8
Q

What is the most common causative bacteria in tonsillitis?

A

Group A bet-haemolytic strep

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9
Q

What are the less common causative bacteria in tonsillitis?

A
  • Staph. aureus
  • Strep. pneumoniae
  • Mycoplasma pneumoniae
  • Chlamydia pneumoniae
  • Bordatella pertussis
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10
Q

What are the risk factors for tonsillitis?

A
  • Immunodeficiency
  • Family history of tonsillitis
  • Family history of atopy
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11
Q

What are the symptoms of tonsillitis?

A
  • Sore throat
  • Odynophagia
  • Pain in ears
  • Headache
  • Loss of voice
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12
Q

What are the signs of tonsillitis?

A
  • Tonsillar erythema
  • White flecks of pus (potentially)
  • Swollen tonsils
  • Pyrexia
  • Swollen regional lymph nodes
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13
Q

How is tonsillitis diagnosed?

A

Clinically

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14
Q

Should throat swabs be performed routinely?

A

No

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15
Q

What are the differentials of tonsillitis?

A
  • Glandular fever
  • HSV
  • Coxsackie infection
  • Malignancy
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16
Q

How will a patient with glandular fever present?

A

Quite unwell with very large purulent tonsils and lethargy

17
Q

How will a patient with coxsackie infection present?

A

Small blisters on tonsils and roof of mouth

18
Q

What happens to the blisters in coxsackie infection?

A

They rupture after a few days and form scabs

19
Q

How can tonsillitis be differentiated from a malignancy usually?

A

The enlargement in malignancy is unilateral

20
Q

What does self-care for tonsillitis include?

A
  • Plenty of rest
  • Gargling with warm salt water
  • Avoiding social contact
  • Antipyretics and analgesia
21
Q

Are antibiotics helpful in the majority of cases of tonsillitis?

A

No

22
Q

What are the indications for antibiotics in tonsillitis?

A
  • Features of marked systemic illness
  • Unilateral peri-tonsillitis
  • History of rheumatic fever
  • Increased risk of infection
  • 3 or more of Centor criteria
23
Q

What are the Centor criteria for tonsillitis?

A
  • History of fever
  • Tonsillar exudate
  • No cough
  • Tender anterior cervical lymphadenopathy
24
Q

What is the antibiotic of choice in tonsillitis?

A

Phenoxymethylpenicillin

25
Q

How long should antibiotics be prescribed in tonsillitis?

A

10 days

26
Q

What antibiotic therapy is used in tonsillitis with penicillin allergy?

A

10 days of clarithromycin

27
Q

What is the aim of a tonsillectomy?

A

To reduce recurrence

28
Q

When is a tonsillectomy indicated?

A
  • Recurrent streptococcal tonsillitis
  • Enlarge tonsils obstructing the airway
  • Possible malignant disease of tonsils
29
Q

What are the potential complications of tonsillitis?

A
  • Peritonsillar abscess
  • Acute otitis media
  • Obstructive sleep apnoea
  • Streptococcal infection may cause guttate psoriasis

A - MSRA ENT [6] (22 decks)

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