Adenotonsillar Disease Flashcards
between what ages do the tonsils usually develop fully?
2 to 10 years
state the main function of the tonsils
trap inhaled pathogens and present to immune system
what is Waldeyer’s ring?
ring of MALT between the oropharynx and the nasopharynx
comprises tonsils, adenoids and lingual tonsils
how does the histology of the tonsils differ from that of the adenoids?
tonsils = specialised squamous, crypts
adenoids = resp epithelium, folds, transitional
true or false: acute tonsillitis is usually bacterial
false
viral
list the main viruses that cause acute tonsillitis
EBV influenza rhinovirus enterovirus adenovirus
what is the most common bacterial cause of acute tonsillitis?
group A strep
why are throat swabs not recommended in acute tonsillitis?
surface bacteria do not always reflect core species
list symptoms of acute viral tonsillitis
malaise
sore throat
temperature
lasts less than a week
list symptoms of acute bacterial tonsillitis
systemic upset fever odynophagia halitosis unable to work lasts over a week
which criteria helps differentiate between viral and bacterial tonsillitis?
centor criteria
how many points on the centor criteria warrants antibiotic use for acute tonsillitis?
2/3 if progressing
4/5 treat empirically
outline conservative management for acute tonsillitis
bed rest
fluids
analgesia
which antibiotics can be given for acute tonsillitis?
penicillin for 10 days
clarithromycin if allergic
true or false: surgery is often done for tonsillitis
false
list indications for tonsillectomy
recurrent severe tonsillitis
well documented visits for tonsillitis
numerous episodes in 2-3 years
true or false: the risk of mortality from tonsillitis is less than the risk of complications of tonsillectomy
true
what is a peritonsillar abscess?
a complication of tonsillitis where infection moves to the space between the tonsil and the muscle
what is the classic history/presentation of a peritonsillar abscess?
tonsillitis improving but developing unilateral throat pain and odynophagia
medial displacement of tonsil and uvula contralaterally
how is peritonsillar abscess treated?
aspiration
antibiotics
what is glandular fever?
infectious mononucleosis caused by EBV
list signs and symptoms of glandular fever
feeling washed out
malaise
tonsillar enlargement with membranous exudate
lymphadenopathy
how is glandular fever diagnosed?
positive monospot or paul bunnell test
true or false: CRP is very high in glandular fever
false
usually below 100
what is the antibiotic of choice for glandular fever?
penicillin
true or false: do not prescribe amoxicillin for tonsillitis or glandular fever
true
