Adenotonsillar Disease Flashcards
main function of the tonsils?
trap bacteria and viruses on inhalation
prevent subsequent infection
when are the tonsils at their biggest?
under 2 years
when do the tonsils start to get smaller?
teenage years
what layer of epithelium is the waldeyers ring located?
subepithelial
what is waldeyers ring?
ring of lymphoid aggregation in the oro and nasopharynx
the palatine tonsil sits in between what 2 structures?
anterior and posterior palatal folds
what kind of epithelium lines the tonsils?
specialised squamous
what kind of epithelium lines the adenoid tonsils?
stratified squamous
the adenoids have crypts instead of folds T or F
F, adenoids have folds instead of crypts
what epithelium is usually found where trauma/food goes?
squamous
what kind of epithelium is found where air goes?
columnar
main aetiology of acute tonsillitis?
viral eg EBV, adenovirus, rhinovirus etc
how common is bacterial tonsillitis?
uncommon
main bacterial cause of tonsillitis?
strep pyogenes GABHS
throat swabs are not recommended for tonsillitis Ix, why?
bacteria will come up even on normal tonsils
how long does viral tonsillitis last?
3-4 days
how long does bacterial tonsillitis last?
1 week
how does bacterial tonsillitis differ from viral symptomatically?
viral = sore throat, not too bad
bacterial= systemic, fever, odynophagia, lymphadenopathy
name the 4 elements on the centor criteria?
history of fever
tonsillar exudates
tendor anterior cervical LNs
absence of cough
what centor score is required for a definite antibiotic prescription?
4+
what centor score means no antibiotics will be prescribed?
<1
antibiotics used to treat tonsillitis (include dose and freq) ?
penicillin 500mg qds
what antibiotic is used if the 1st line Ab is allergic?
clarithromycin
how many sore throats are needed in 3 years to qualify for a tonsillectomy?
3
how many sore throats are needed in 2 years to qualify for a tonsillectomy/
5
how many sore throats are needed in a year to qualify for a tonsillectomy?
7
main symptoms after a tonsillectomy?
severe pain
bleeding
a peritonsilar abscess always preceeds tonsillitis T or F
T
classic history of a peritonsilar abscess?
unilateral throat pain
odynophagia
acute tonsillitis preceding
lockjaw
is pain in quinsy unilateral?
yes
another word for peritonsillar abscess?
quinsy
Tx of quinsy
aspiration
antibiotics
medical name for lockjaw?
trismus
palatal petechian haemorrhages are present in glandular fever and not tonsillitis T or F
T
what is different about the lymphadenopathy in glandular fever compared to tonsillitis?
more generalised in glandular fever eg inguinal nodes are involved
Ix for glandular fever?
EBV IgM test
is CRP higher in glandular fever or tonsillitis?
tonsillitis (>200)
<100 in glandular fever
what antibiotic should definitely not be prescribed for glandular fever and why?
amoxicillin
brings patient out in a generalised macular rash
main symptoms of obstructive hyperplasia?
nasal voice
snoring
sleep disturbance
what malignant cancers can cause unilateral tonsillar enlargement?
non-hodgkins lymphoma
SCC
