Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENT SM > Adenotonsillar Disease and Otitis Media with Effusion > Flashcards

Adenotonsillar Disease and Otitis Media with Effusion Flashcards

1
Q

Where does the tonsillar fossa and palatine tonsils develop from

A

The 1st pharyngeal pouch and the 2 pouch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the main function of the tonsils

A

To trap bacteria and viruses on inhalation

Help to prime immune system and prevent subsequent infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

At what age is significant adenotonsilar enlargement unusual?

A

under 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What structures make up Waldeyer’s ring

A

Tonsils (palatine)
Adenoids
Lingual tonsil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is the Waldeyer’s ring located

A

In the sub epithelial layer of oropharynx and nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The tonsil is nestled in a fossa formed by muscles. What muscles are they

A

anterior and posterior tonsillar pillars (palatoglossus and palatopharyngeus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the anatomical location of the adenoid

A

In the midline of the posterior wall of the Nasopharynx immediately inferior to the rostrum of the sphenoid
It makes up most of the Waldeyer’s ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of cells cover the surface of the tonsil

A

Stratified squamous epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does the surface of the adenoids differ from the surface of the tonsils

A

Adenoids have deep folds and few crypts

Tonsils have from 10-30 crypts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of cells are found where air goes e.g. nose, PNS, larynx and trachea

A

columnar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of cells are found where food goes e.g. oral, pharyngeal, vocal cords, oesophagus

A

Squamous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of cells are found in the upper aerodigestive

A

Ciliated columnar respiratory type mucosa and squamous epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name some common diseases of the tonsils and adenoids

A 
acute tonsillitis 
recurrent/ chronic adenoiditis / tonsilitis 
Obstructive hyperplasia 
malignancy 
tonsil crypt debris / tonsiliths
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the main causes of acute tonsillitis

A 
Majority viral (EBV or Rhinovirus, influenza etc) 
Some bacterial (up to 30%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why are throat swabs discouraged

A

Core species do not always correlate with surface bacteria - does not confirm causative organism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some of the most commonly cultured organisms from patients with chronic tonsillar disease

A

Strep pyogenes
H influenza
S aureus
Strep pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What else should be included in a differential diagnosis of Acute tonsillitis

A 
URTI viral infection 
Infectious mononucleosi 
Peritonsilar abscess
Candida infection 
Malignancy: lymphoma, leukaemia, carcinoma 
Diptheria 
Scarlet fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are symptoms of viral tonsillitis

A 
Malaise
Sore throat 
Temperature 
Lasts 3-4 days 
lymphadenopathy (possibility)
Able to undertake normal activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are symptoms of bacterial symptoms of tonsillitis

A 
Systemic upset 
fever 
odynophagia 
halitosis 
unable to work/ school
lymphadenopathy (tonsilar nodes particularly) 
lasts 1 week
Requires antibiotics
20
Q

What criteria helps us to differentiate between viral and bacterial tonsillitis

A

Centor Criteria

21
Q

What are the 4 major points in the centor criteria

A

History of fever
Tonsillar exudates
Tender anterior cervical adenopathy
Absence of cough

22
Q

What is the supportive treatment for tonsillitis

A

Eat and drink
Rest
TOC analgesia

23
Q

What antibiotic should be prescribed if necessary for tonsilitis

A

Penicillin 500mg qid for 10 days

Clarithromycin if allergic

24
Q

If hospital admission is required for tonsillitis, wha would be involved

A

IV fluids
IV antibiotics
Steroids

25
Q

What are the downfalls of surgical management of tonsillitis

A

Very sore after
Bad day around day 5 then get better
strong opiates can be required
Lots of scarring post op

26
Q

How does a peritonsilar abscess arise

A

A complication of acute tonsillitis

Bacteria between muscle and tonsil produce pus

27
Q

What is a classic history of a peritonsilar abscess

A

Unilateral throat pain and odynophagia (pain on swallowing in the mouth)
Trismus (mouth tightly closed)
3-7 days of preceding acute tonsillitis

28
Q

What is the treatment for a peritonsilar abscess

A

Aspiration and antibiotics

29
Q

What are some signs of glandular fever

A 
Fross tonsillar enlargement with membranous exudate 
Marked cervical lymphadenopathy 
Palatal petechial haemorrhages 
Generalised lymphadenopathy 
Hepatosplenomegaly
30
Q

How is a diagnosis of Glandular fever made

A

Atypical lymphcocytes in peripheral blood
+ve monospot or paul bunnell test
low CRP

31
Q

What should not be prescribed in a patient with glandular fever and why

A

Amoxicillin - it causes a generalised macular rash

32
Q

What are some symptoms of chronic tonsillitis

A 
Chronic sore throat 
Malodorous breath 
Presence of tonsilliths 
Peritonsillar erythema 
Persistent tender cervical lymphadenopathy
33
Q

What are some symptoms of obstructive hyperplasia of the adenoids

A

Obligate mouth breathing
Hypo nasal voice
Snoring and other signs of sleep disturbance

34
Q

What are some symptoms of obstructive hyperplasia of the tonsils

A

Snoring and other symptoms of sleep disturbance
Muffled voice
Dysphagia

35
Q

What is glue ear

A

Fluid in the middle ear space

Inflammation of the middle ear accompanied by accumulation of fluid without the symptoms and signs of acute inflammation

36
Q

What is acute otitis media

A

Inflammation of the middle ear accompanied by the symptoms of acute inflammation with or without an accumulation of fluid

37
Q

What sex is more likely to develop OME

A

Males

38
Q

Why is there an increased incidence of children with OME

A

Day care
older siblings
smoking household
recurrent URTI

39
Q

What are some symptoms of OME

A

Deafness
poor school performance
behavioural problems
speech delay - low frequency problems

NOT otalgia

40
Q

What does tympanometry measure

A

Pressure

41
Q

How is a diagnosis of OME made

A 
History 
Otoscopy 
Tuning fork tests 
Audiometry 
Tympanometry
42
Q

What are some signs of OME

A

TM retraction
reduced TM mobility
Altered TM colour
Visible ME fluid/ bubbbles

43
Q

What is the treatment for OME

A

Watchful waiting and review at 3 months
At 3 months: otoscopy, PTA, tympanometry
Explanaiton

44
Q

What is the surgical management for

A

grommets

45
Q

What are some complications of OME

A

Weak evidence of short term speech language and behavioural development problems
No clear evidence of long term problems

46
Q

What are some complications of grommets

A 
Infection / dishcarge 
Early extrusion
Retention
Persistent perforation
Swimming /bathing issues

ENT SM (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions