Adenotonsillar Disease Flashcards
What are some functions of the adenoids and tonsils?
Trap bacteria and viruses
Produce antibodies
Prime immune system
What is Waldeyer’s ring comprised of?
Tubal tonsil
Palatine tonsil
Lingual tonsil
Pharyngeal tonsil
Acute tonsillitis is usually viral/bacterial
Viral
What is the most important bacterial pathogen in acute tonsillitis?
GABHS
Are throat swabs indicated in acute tonsillitis?
No
What are the commonest causative organisms of bacterial tonsillitis?
Strep pyogenes
H. influenzae
Staph aureus
Strep pneumoniae
In viral/bacterial tonsillitis, one is able to go about their daily life
Viral
What are the variables in the centor criteria?
Fever
Exudates
Tender anterior lymphadenopathy
No cough
How is tonsillitis with a low centor criteria treated?
Supportive - rest and paracetamol
What antibiotics are used to treat tonsillitis?
Penicillin (500mg qid for 10 days)
Clarithromycin if pen-allergic
What may be given if antibiotics do not work in acute tonsillitis?
Steroids
How many episodes of tonsillitis are required in a year before being considered for tonsillectomy?
7
What occurs in peritonsilar abscess (quinsy)?
Bacteria between muscle and tonsil produce pus
What are the symptoms of peritonsilar abscess?
Unilateral throat pain
Odynophagia
Trismus
What is the cause of glandular fever?
EBV
Give some signs and symptoms of glandular fever
Tonsillar enlargement
Cervical lymphadenopathy
Hepatosplenomegaly
How is glandular fever diagnosed?
Atypical lymphocytes in peripheral blood
EBV IgM in blood
What is glue ear?
Inflammation of the middle ear accompanied by accumulation of fluid without symptoms/signs of acute inflammation
What is acute otitis media?
Inflammation of the middle ear with symptoms and signs of acute inflammation
What is thought to be the cause of otitis media with effusion?
Eustachian tube isn’t working as well causing negative pressure in middle ear that drives fluid in
What is the main symptom of otits media with effusion?
Hearing loss
What are the symptoms of acute otitis media?
Earache/fever/irritability
What investigations are done to diagnose OME/AOM?
Otoscopy
Tuning fork tests
Audiometry
Tympanometry
What are signs of OME on otoscopy?
Tympanic membrane retraction
Altered colour
How long should one wait before referring in OME?
3 months
What is the treatment for OME?
Grommets
Adenoidectomy
