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Year Two - Ears, Nose & Throat > Tonsillitis > Flashcards

Tonsillitis Flashcards

1
Q

What are the palantine tonsils?

A

They are lymphoid tissues located in the lateral walls of the oropharynx

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2
Q

What are tonsillitis?

A

It is defined as a condition in which there is inflammation of the palatine tonsils

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3
Q

What are the two classifications of tonsillitis?

A

Viral Tonsillitis

Bacterial Tonsillitis

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4
Q

What is the most common tonsillitis classification?

A

Viral Tonsillitis

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5
Q

What is viral tonsillitis?

A

It is defined as tonsillitis related to viral infection

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6
Q

What four causative organisms are associated with viral tonsillitis?

A

Rhinovirus

Coronavirus

Parainfluenza Virus

Epstein Barr Virus

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7
Q

What is the most comon causative organism associated with viral tonsillitis?

A

Rhinovirus

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8
Q

What is bacterial tonsillitis?

A

It is defined as tonsillitis related to bacterial infection

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9
Q

What five causative organisms are associated with bacterial tonsillitis?

A

Streptococcus Pyogenes

Streptococcus Pneumoniae

Staphylococcus Aureus

Haemophilus Influenzae

Moraxella Catarrhalis

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10
Q

What is the most comon causative organism associated with bacterial tonsillitis?

A

Streptococcus Pyogenes

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11
Q

What are the ten clinical features of tonsillitis?

A

Fever > 38C

Sore Throat

Odynophagia

Dysphagia

Dysphonia

Swollen Palatine Tonsils

Erythematous Palatine Tonsils

Palantine Tonsil Exudates

Peritonsillar Abscess

Cervical Lymphadenopathy

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12
Q

What is odynophagia?

A

It is defined as painful swallowing

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13
Q

What is dysphagia?

A

It is defined as difficulty in swallowing

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14
Q

What is dysphonia?

A

It is defined as an abnormal voice

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15
Q

What are tonsilar exudates?

A

They are defined as white patches of pus on the tonsils

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16
Q

What are the two investigations used to diagnose tonsillitis?

A

CENTOR Criteria

FeverPAIN Criteria

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17
Q

How is the CENTOR criteria used to investigate tonsilitis?

A

It is used to determine the probability that tonsillitis is due to bacterial infection, and will therefore benefit from antibiotic management

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18
Q

What is the CENTOR criteria?

A

Tonsillar Exudate = 1 Score

Tender Anterior Cervical
Lymphadenopathy = 1 Score

Fever > 38C = 1 Score

Cough Absence = 1 Score

19
Q

What does a CENTOR criteria score of 0-2 indicate?

A

It indicates that there is a low probability of bacterial infection, and therefore it should be managed conservatively

20
Q

What does a CENTOR criteria score of > 3 indicate?

A

It indicates that there is a high probability of bacterial infection, and therefore it should be managed pharmacologically with antibiotics

21
Q

How is the FeverPAIN criteria used to investigate tonsillitis?

A

It is used to determine the probability that tonsillitis is due to bacterial infection, and will therefore benefit from antibiotic management

22
Q

What is the FeverPAIN criteria?

A

Fever > 38C = 1 Score

Purulence (Tonsillar Pus) =.1 Score

Attended Within 3 Days of Clinical Onset = 1 Score

Severely Inflamed Tonsils = 1 Score
No Cough/Coryza = 1 Score

23
Q

What does a FeverPAIN criteria score of 0 - 1?

A

It indicates that there is a low probability of bacterial infection, and therefore it should be managed conservatively

24
Q

What does a FeverPAIN criteria score of 2 - 3 indicate?

A

It indicates that there is a moderate probability of bacterial infection, and therefore it can either be managed conservatively OR pharmacologically with a delayed antibiotic prescription – which should be used if clinical features don’t resolve within 3 – 5 days or if they deteriorate

25
What does a FeverPAIN criteria score of 4 - 5 indicate?
It indicates that there is a high probability of bacterial infection, and therefore it should be managed pharmacologically with antibiotics
26
When is conservative management used to treat acute tonsillitis?
CENTOR criteria score < 3 OR FeverPAIN score < 4
27
What are the three conservative management options of acute tonsillitis?
Rest Hydration Paracetamol +/- Ibuprofen
28
What safety netting advice should be provided when acute tonsillitis is managed conservatively?
It is recommended to return if clinical features have not settled after 3 days or the fever rises above 38.3C
29
When is pharmacological management used to treat acute tonsillitis?
CENTOR criteria score > 3 OR FeverPAIN score > 4
30
What are the two pharmacological management options of acute tonsillitis?
Beta-Lactam Antibiotics Macrolide Antibiotics
31
When are beta-lactam antibiotics used to manage acute tonsillitis?
They are the first line pharmacological management option
32
Name a beta-lactam antibiotic used to manage acute tonsillitis. How long is the antibiotic course?
Phenoxymethylpenicillin 10 day course
33
When are macrolide antibiotics used to manage acute tonsillitis?
They are the second line pharmacological management option
34
Name two macrolide antibiotics used to manage acute tonsillitis. How long is the antibiotic course?
Clarithromycin Erythromycin 5 day course
35
What is the surgical management option of chronic tonsillitis?
Tonsillectomy
36
When is tonsillectomy used to manage chronic tonsillitis?
It is recommended in recurrent tonsillitis, which meets **all** of the following criteria... * > 5 Tonsillitis Episodes In One Year * Clinical Features Persisting For > 1 Year * Sore Throat Related To Tonsillitis * Tonsillitis Episodes Functionally Impairing
37
What is a common complication of tonsillectomies?
Post-Tonsillectomy Haemorrhage
38
What is the most appropriate management option in suspected post-tonsillectomy haemorrhage?
Urgent ENT surgeon and anaesthetist referral
39
What is primary post-tonsillectomy haemorrhage?
It is defined as haemorrhage which occurs within 24 hours of tonsillectomy
40
What is the management option of primary post-tonsillectomy haemorrhage?
Immediate return to theatre
41
What is secondary post-tonsillectomy haemorrhage?
It is defined as haemorrhage which occurs between 24 horus and 10 days of tonsillectomy
42
What is the management option of secondary post-tonsillectomy haemorrhage?
Secondary care admission IV antibiotics
43
What are the eight complications associated with tonsillitis?
Chronic Tonsillitis Peritonsillar Abscess (Quinsy) Otitis Media Sinusitis Scarlet Fever Rheumatic Fever Post-Streptococcal Glomerulonephritis Post-Streptococcal Reactive Arthritis

Year Two - Ears, Nose & Throat (12 decks)

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