Adenotonsillar Disease

Question 1

tonsillitis is infection of the _____ tonsils

Answer 1

palatine

Question 2

aetiology of tonsillitis

Answer 2

70% viral

rest- bacterial (strep pyogenes, h-influenzae, s.aureaus)

Question 3

difference in presentation between bacterial and viral tonsillitis

Answer 3

viral- can still do stuff. bacterial- really rough/sick

Question 4

feverPAIN criteria

Answer 4

fever, purulent tonsils, attend clinic, inflamed tonsils, no cough

Question 5

mx for tonsillitis

Answer 5

supportive, abx for high feverPAIN score- phenoxymethylpenicillin, clarithrymycin if allergic to penicillin

Question 6

when to consider surgery for tonsillitis

Answer 6

> 10to, recurrent sore throat (>7), severley debilitating

Question 7

main tonsillitis comps

Answer 7

Quincy (peritonsillar abscess), paraphrayngeal abscess

Question 8

what is Quincy

Answer 8

bacteria from acute tonsillitis penetrates the muscle

Question 9

s/s of Quincy

Answer 9

unilateral throat pain, odynopagia, trismus

signs- medial displacement of tonsil, uvea moves away from affected side

Question 10

mx of Quincy

Answer 10

aspirate and abx

Question 11

obstructive hyperplasia is what

Answer 11

tonsillar and adenoids tend to swell causing issues

Question 12

s/s of obstructive hyperplasia

Answer 12

snoring, obligate mouth breathers, voice changes

Question 13

when do you remove adenoids/ tonsils in kids

Answer 13

if they have obstructive sleep apnoea

Question 14

what is a pharyngeal pouch

Answer 14

out-pouching of pharyngeal mucosa occurring between cricopharyngius and thyrophfaryngius muscles

Question 15

s/s of pharyngeal pouch

Answer 15

progressive dysphagia, lump in throat, halitosis, reflux of food

Question 16

ix & mx for pharyngeal pouch

Answer 16

Ba swallow, rigid oesophagoscopy

mx- staple if symptomatic