Tonsillitis Flashcards
What are kissing tonsils
enlarged, edematous palatine tonsils that meet in the midline and obstruct the passage of air or food
seen in tonsillitis
What could cause mouth breathing
enlarged adenoids
positive dry and irritated mucous membranes of the oropharynx
what are clinical manifestations of tonsillitis?
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
Is tonsillectomy indicated in the child who has recurrent pharyngitis?
NO
When is tonsillectomy indicated?
Indicated for:
recurrent and frequent streptococcal infection
history of development of a peritonsillar abscess
airway obstruction
sleep apnea
chronic feeding difficulty
How old does a child have to be to have a tonsillectomy?
over 3 years old due to hypertrophy of remaining tissues
When is tonsillectomy contraindicated?
in
active infection
cleft palate
What is otitis-conjunctivitis connection?
It is when a person with a sore throat develops an asymptomatic otitis media and symptomatic conjunctivitis
associated with purulent rhinitis
What bacteria is responsible for otitis-conjunctivitis connection?
Haemophilus influenza
What is treatment for this?
Systemic antibiotics: Augmentin Ceftin Pediazole Bactrim
What other condition causes marked tonsillitis?
Infectious Mononucelosis caused by the Epstein Barr virus
Called the “kissing disease” because transmitted by saliva
How long is the incubation period with mono?
2-6 weeks
How long can the virus of mono be shed?
2 to 6 months
What is most common age for mono?
15-30 years old
rare under 5 years of age
What are clinical manifestations of mono?
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
What tests can you do to check for mono?
Mono spot EBV titers (which shows if patient having acute, resolving episode or if patient has had mono in the past)
What is treatment for mono
High amount of rest No contact sports for 4 weeks until the spleen has healed Tylenol NSAIDS increase fluid
What are two other causes of pharyngitis?
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.
What is gingivostomatitis?
1st presentation of herpes simplex virus
What are the manifestations of gingivostomatitits?
vesicular lesions of tongue, labial, buccal and gingival mucosa
with fever and malaise
What is treatment of gingivostomatititis?
If outbreak caught within first 72 hours can treat with anti-virals.
