Resp - ENT Flashcards
What is tonsillitis?
A form of pharyngitis with intense inflammation of the tonsils
Often with purulent exudate
What are the common pathogens causing tonsillitis?
Group A ß-haemolytic streptococci
Eppstein-Barr virus (infectious mononucleosis)
Which clinical features are more common with bacterial tonsillitis than viral?
Marked constitutional disturbance:
Headache
Apathy
Abdo pain
White tonsillar exudate
Cervical lymphadenopathy
1/3 are bacterial
What advice can you give parents about caring for a child with tonsillitis?
Bacterial vs. viral (which will get better on its own)
Drink a lot of fluids
Plenty of rest
Serve liquids and soft foods if hard to eat (including ice cream lol)
Keep child’s glasses and utensils separate and wash thoroughly in hot, soapy water
Acetaminophen or ibuprofen for pain relief, NOT aspirin!! (Reye syndrome)
Everyone in the family to wash their hands very often, because very contagious
What different courses can tonsilitis go?
Acute
Recurrent
Chronic
What are the symptoms of acute tonsillitis? How long?
Fever Sore throat Foul Breath Dysphagia Odynophagia (painful) Tender cervical LN
Possible airway obstruction
Lethargy
Normally lasts 3-4 days, but up to 2 weeks
When is tonsillitis recurrent?
7 in 1 year
5 in 2 years
3 in 3 years
Needs to be diagnosed with GABHS each time
At which age is otitis media most common?
6-12 months
How many children have at least 1 episode of otitis media (and >3)?
Almost all children get it once.
20% get it >3
Why are children prone to otitis media?
Short Eustachian tube
Horizontal and poorly functional too
What are the pathogens causing otitis media?
Viruses (RSV, rhinovirus)
Bacteria (pneumococcus, non-typeable H.influenza, Moraxella catarrhalis)
What are the complications of otitis media? (and thus its importance)
Mastoiditis
Meningitis
(both uncommon)
Symptoms of otitis media?
Ear pain
Fever
If recurrent, otitis media with effusion (may cause speech and learning difficulties, hearing loss)
What treatment is available for otitis media?
Analgesia (regular paracetamol or ibuprofen)
Most resolve spontaneously
Antibiotics shorten duration of pain but not the risk of hearing loss
(should only use if child remains unwell after 2-3 days)
eg. amoxicillin
What is usually the treatment for otitis media with effusion?
Grommet insertion (ventilation tubes)
If subsequent recurrence, adenoidectomy
What is the peak age of otitis media with effusion?
2.5-5 years (very common at that age)