Pathology of the throat Flashcards

1
Q

What is Waldeyer’s ring?

A

Ring of tonsillar/lymphoid aggregation in the subepithelial layer of the oropharynx and nasopharynx

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2
Q

What does Waldeyer’s ring consist of?

A

Palantine tonsils

Adenoids (pharyngeal tonsil)

Lingual tonsil

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3
Q

What are the histological characteristics of tonsils?

A

Specialised squamous epithelium

Deep crypts

Lymphoid follicles

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4
Q

What are the histological characteristics of adenoids?

A

Ciliated pseudostratified columnar epithelium

Stratified squamous

Transitional

Deep folds

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5
Q

What are some of the causal organisms of acute tonsilitis?

A

Usually viral:
Epstein-Barr virus

Rhinovirus

Influenza

Adenovirus

Enterovirus

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6
Q

What are some of the causal organisms in chronic tonsilitis?

A

Usually bacterial:

Strep. pyogenes

H. influenza

Staph. aureus

Strep. pneumonaie

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7
Q

What are some of the symptoms of viral tonsilitis?

A

Malaise

Sore throat

Temperature

Lymphadenopathy

3-4 days duration

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8
Q

What are some of the symptoms of bacterial tonsilitis?

A

Systemic upset

Fever

Odonophagia

Halitosis

Lymphadenopathy

~1 week duration

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9
Q

What is the treatment for tonsilitis?

A

Rest

Analgesia

Antibiotics - penecillin, clarithromycin if allergic

Surgery

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10
Q

What are some of the complications of tonsillectomy?

A

Very painful afterwards - day 5 worst day

5% risk of haemorrhage

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11
Q

What is a peritonsillar abscess?

A

A collection of pus in a tonsil - a complication of acute tonsilitis

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12
Q

What are the symptoms of peritonsilar abscess?

A

Unilateral throat pain and odonophagia

Occurs 3-7 days post tonsilitis

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13
Q

What signs on examination indicate peritonsillar abscess?

A

Loss of concavity of palatine arches

Medial displacement of tonsils and uvula

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14
Q

What is the treatment for peritonsillar abscess?

A

Aspiration and antibiotics

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15
Q

What is the causal organism of glandular fever/infectious mononucleosis?

A

Epstein-Barr virus

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16
Q

What signs on examination indicate glandular fever?

A

Gross tonsillar enlargement with membranous exudate

Marked cervical lympadenopathy

Palatal petechial haemorrhages

Generalised lymphadenopathy

Hepatosplenomegaly

17
Q

How is the diagnosis of glandular fever made?

A

Atypical lymphocytes in peripheral blood

Positive monospot or Paul-Bunnell test

Low CRP

18
Q

What is the treatment for glandular fever?

A

Antibiotics
Steroids

19
Q

Which antibiotic should not be used for glandular fever and why?

A

Ampicillin/amoxicillin

Casuses a macular rash

20
Q

What are the symptoms of chronic tonsilitis?

A

Chronic sore throat

“Bad breath”

Tonsil stones

Peritonsillar erythema

Persistant tender cervical lymphadenopathy

21
Q

What are the symptoms of tonsil hyperplasia?

A

Dysphagia

Snoring and other sleep disturbance

Muffled voice

22
Q

What are the symptoms of adenoid hyperplasia?

A

Obligate mouth breathing

AOM/OME

Hyponasal voice

Snoring and other sleep disturbance