Tonsillitis

Question 1

What are kissing tonsils

Answer 1

enlarged, edematous palatine tonsils that meet in the midline and obstruct the passage of air or food
seen in tonsillitis

Question 2

What could cause mouth breathing

Answer 2

enlarged adenoids

positive dry and irritated mucous membranes of the oropharynx

Question 3

what are clinical manifestations of tonsillitis?

Answer 3

caused by inflammation
kissing tonsils
difficulty swallowing and breathing
mouth breathing from enlarged adenoids
dry and irritated mucous membranes of the oropharynx= offensive mouth odor and impaired sense of taste and smell
nasal and muffled voice= air cannot be trapped for proper speech sounds
persistent cough
OM= proximity of the adenoids to the Eustachian tubes = passageway is frequently blocked by swollen adenoids, interfering with normal drainage

Question 4

Is tonsillectomy indicated in the child who has recurrent pharyngitis?

Answer 4

NO

Question 5

When is tonsillectomy indicated?

Answer 5

Indicated for:
recurrent and frequent streptococcal infection
history of development of a peritonsillar abscess
airway obstruction
sleep apnea
chronic feeding difficulty

Question 6

How old does a child have to be to have a tonsillectomy?

Answer 6

over 3 years old due to hypertrophy of remaining tissues

Question 7

When is tonsillectomy contraindicated?

Answer 7

in
active infection
cleft palate

Question 8

What is otitis-conjunctivitis connection?

Answer 8

It is when a person with a sore throat develops an asymptomatic otitis media and symptomatic conjunctivitis
associated with purulent rhinitis

Question 9

What bacteria is responsible for otitis-conjunctivitis connection?

Answer 9

Haemophilus influenza

Question 10

What is treatment for this?

Answer 10

Systemic antibiotics:
Augmentin
Ceftin
Pediazole
Bactrim

Question 11

What other condition causes marked tonsillitis?

Answer 11

Infectious Mononucelosis caused by the Epstein Barr virus

Called the “kissing disease” because transmitted by saliva

Question 12

How long is the incubation period with mono?

Answer 12

2-6 weeks

Question 13

How long can the virus of mono be shed?

Answer 13

2 to 6 months

Question 14

What is most common age for mono?

Answer 14

15-30 years old

rare under 5 years of age

Question 15

What are clinical manifestations of mono?

Answer 15

fever 102-104
headache
severe fatigue
sore throat 
malaise
pharyngeal injection with exudate
POSTERIOR cervical lymphadenopathy
hepatosplenomegaly (sometimes)
splenomegaly
lymphocytosis
Atypical lymphocytes on CBC
palantine petichiae at the hard and soft palate

Question 16

What tests can you do to check for mono?

Answer 16

Mono spot 
EBV titers (which shows if patient having acute, resolving episode or if patient has had mono in the past)

Question 17

What is treatment for mono

Answer 17

High amount of rest
No contact sports for 4 weeks until the spleen has healed
Tylenol
NSAIDS
increase fluid

Question 18

What are two other causes of pharyngitis?

Answer 18

Herpangina: headache, fever and malaise often accompanied by sinus tachycardia; small oral vesicles or ulcers on tonsils, uvula and soft palate.

Hand foot mouth disease:
large vesiculated ulcers in the oropharynx and on the palms and soles, buttocks and diaper area.

Question 19

What is gingivostomatitis?

Answer 19

1st presentation of herpes simplex virus

Question 20

What are the manifestations of gingivostomatitits?

Answer 20

vesicular lesions of tongue, labial, buccal and gingival mucosa
with fever and malaise

Question 21

What is treatment of gingivostomatititis?

Answer 21

If outbreak caught within first 72 hours can treat with anti-virals.