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2 ENT > Adenotonsillar Disease > Flashcards

Adenotonsillar Disease Flashcards

1
Q

main function of the tonsils?

A

trap bacteria and viruses on inhalation

prevent subsequent infection

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2
Q

when are the tonsils at their biggest?

A

under 2 years

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3
Q

when do the tonsils start to get smaller?

A

teenage years

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4
Q

what layer of epithelium is the waldeyers ring located?

A

subepithelial

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5
Q

what is waldeyers ring?

A

ring of lymphoid aggregation in the oro and nasopharynx

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6
Q

the palatine tonsil sits in between what 2 structures?

A

anterior and posterior palatal folds

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7
Q

what kind of epithelium lines the tonsils?

A

specialised squamous

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8
Q

what kind of epithelium lines the adenoid tonsils?

A

stratified squamous

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9
Q

the adenoids have crypts instead of folds T or F

A

F, adenoids have folds instead of crypts

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10
Q

what epithelium is usually found where trauma/food goes?

A

squamous

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11
Q

what kind of epithelium is found where air goes?

A

columnar

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12
Q

main aetiology of acute tonsillitis?

A

viral eg EBV, adenovirus, rhinovirus etc

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13
Q

how common is bacterial tonsillitis?

A

uncommon

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14
Q

main bacterial cause of tonsillitis?

A

strep pyogenes GABHS

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15
Q

throat swabs are not recommended for tonsillitis Ix, why?

A

bacteria will come up even on normal tonsils

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16
Q

how long does viral tonsillitis last?

A

3-4 days

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17
Q

how long does bacterial tonsillitis last?

A

1 week

18
Q

how does bacterial tonsillitis differ from viral symptomatically?

A

viral = sore throat, not too bad

bacterial= systemic, fever, odynophagia, lymphadenopathy

19
Q

name the 4 elements on the centor criteria?

A

history of fever
tonsillar exudates
tendor anterior cervical LNs
absence of cough

20
Q

what centor score is required for a definite antibiotic prescription?

A

4+

21
Q

what centor score means no antibiotics will be prescribed?

A

<1

22
Q

antibiotics used to treat tonsillitis (include dose and freq) ?

A

penicillin 500mg qds

23
Q

what antibiotic is used if the 1st line Ab is allergic?

A

clarithromycin

24
Q

how many sore throats are needed in 3 years to qualify for a tonsillectomy?

A

3

25
Q

how many sore throats are needed in 2 years to qualify for a tonsillectomy/

A

5

26
Q

how many sore throats are needed in a year to qualify for a tonsillectomy?

A

7

27
Q

main symptoms after a tonsillectomy?

A

severe pain

bleeding

28
Q

a peritonsilar abscess always preceeds tonsillitis T or F

A

T

29
Q

classic history of a peritonsilar abscess?

A

unilateral throat pain
odynophagia
acute tonsillitis preceding
lockjaw

30
Q

is pain in quinsy unilateral?

A

yes

31
Q

another word for peritonsillar abscess?

A

quinsy

32
Q

Tx of quinsy

A

aspiration

antibiotics

33
Q

medical name for lockjaw?

A

trismus

34
Q

palatal petechian haemorrhages are present in glandular fever and not tonsillitis T or F

A

T

35
Q

what is different about the lymphadenopathy in glandular fever compared to tonsillitis?

A

more generalised in glandular fever eg inguinal nodes are involved

36
Q

Ix for glandular fever?

A

EBV IgM test

37
Q

is CRP higher in glandular fever or tonsillitis?

A

tonsillitis (>200)

<100 in glandular fever

38
Q

what antibiotic should definitely not be prescribed for glandular fever and why?

A

amoxicillin

brings patient out in a generalised macular rash

39
Q

main symptoms of obstructive hyperplasia?

A

nasal voice
snoring
sleep disturbance

40
Q

what malignant cancers can cause unilateral tonsillar enlargement?

A

non-hodgkins lymphoma

SCC

2 ENT (13 decks)

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