Tonsilitis Flashcards
When are the tonsils lost by?
age of 40
What is Waldeyers Ring?
ring of tonsils in the subepithelial layer of the oropharynx and nasopharynx
What is the histology of tonsils?
stratified squamous epithelium which forms crypts
What is the histology of adenoids?
pseudostratified columnar epithelium with deep folds and few crypts
under this layer there is stratified squamous epithelium that thickens with infection, then a transitional layer that is responsible for antigen processing
What are the most common viral causes of Acute Tonsilitis?
EBV Rhinovirus Influenzae Parainfluenzae Enterovirus Adenovirus
What are the most common bacterial causes of Acute tonsillitis?
strep pyogenes
H. influenzar
staph aureus
strep pneumoniae
What percentage of Acute tonisilitises are bacterial?
5-10%
What are the symptoms of viral acute tonsilitis?
malaise sore throat mild analgesia temperature lasts 3-4 days still do normal routine possble lympadenopathy
What are the symptoms of bacterial acute tonsilitis?
systemic upset fever odynophagia halitosis unable to work/school lymphadenopathy lasts around a week
What criteria is used to asses whether to give antibiotics to acute tonsilitis?
CENTOR Fever PAIN criteria
What must the patient score in the CENTOR criteria to get antibiotics?
2-3 points = antibiotics if symptoms proogress
4-5 points = treat empirically with antibiotics
What is the general treatment for acute tonsilitis?
rest and eat and drink
NSAIDs and paracetamol
Antibiotics - penicillin (clarithromycin if allergic)
What are the indications for a tonsilectomy?
episodes are disabling and prevent normal function
7 or more clinically significant sore throats in the preceeding year OR 5 or more in each of the preceding 2 years OR 3 or more in each of the 3 preceding years
What are the risks of tonsilectomy?
haemorrhage
What are the complications of Acute tonsilitis?
peritonsilar abscess - quinsy
