Tonsillitis Flashcards

1
Q

What is tonsillitis?

A

Inflammation of the tonsils

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2
Q

What are the tonsils?

A

Collections of lymphoid tissue facing into the aerodigestive tract

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3
Q

What is Waldeyer’s ring?

A

A set of lymphatic tissues (tonsils)

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4
Q

What does Waldeyer’s ring consist of?

A
  • Adenoid tonsils
  • Tubal tonsils
  • Palatine tonsils
  • Lingual tonsil
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5
Q

What is the most common cause of tonsillitis?

A

Viral infection

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6
Q

What are the viral causes of tonsillitis?

A
  • Adenovirus
  • Rhinovirus
  • Influenza
  • Coronavirus
  • RSV
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7
Q

What is the second most common cause of tonsillitis?

A

Bacterial infection

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8
Q

What is the most common causative bacteria in tonsillitis?

A

Group A bet-haemolytic strep

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9
Q

What are the less common causative bacteria in tonsillitis?

A
  • Staph. aureus
  • Strep. pneumoniae
  • Mycoplasma pneumoniae
  • Chlamydia pneumoniae
  • Bordatella pertussis
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10
Q

What are the risk factors for tonsillitis?

A
  • Immunodeficiency
  • Family history of tonsillitis
  • Family history of atopy
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11
Q

What are the symptoms of tonsillitis?

A
  • Sore throat
  • Odynophagia
  • Pain in ears
  • Headache
  • Loss of voice
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12
Q

What are the signs of tonsillitis?

A
  • Tonsillar erythema
  • White flecks of pus (potentially)
  • Swollen tonsils
  • Pyrexia
  • Swollen regional lymph nodes
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13
Q

How is tonsillitis diagnosed?

A

Clinically

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14
Q

Should throat swabs be performed routinely?

A

No

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15
Q

What are the differentials of tonsillitis?

A
  • Glandular fever
  • HSV
  • Coxsackie infection
  • Malignancy
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16
Q

How will a patient with glandular fever present?

A

Quite unwell with very large purulent tonsils and lethargy

17
Q

How will a patient with coxsackie infection present?

A

Small blisters on tonsils and roof of mouth

18
Q

What happens to the blisters in coxsackie infection?

A

They rupture after a few days and form scabs

19
Q

How can tonsillitis be differentiated from a malignancy usually?

A

The enlargement in malignancy is unilateral

20
Q

What does self-care for tonsillitis include?

A
  • Plenty of rest
  • Gargling with warm salt water
  • Avoiding social contact
  • Antipyretics and analgesia
21
Q

Are antibiotics helpful in the majority of cases of tonsillitis?

22
Q

What are the indications for antibiotics in tonsillitis?

A
  • Features of marked systemic illness
  • Unilateral peri-tonsillitis
  • History of rheumatic fever
  • Increased risk of infection
  • 3 or more of Centor criteria
23
Q

What are the Centor criteria for tonsillitis?

A
  • History of fever
  • Tonsillar exudate
  • No cough
  • Tender anterior cervical lymphadenopathy
24
Q

What is the antibiotic of choice in tonsillitis?

A

Phenoxymethylpenicillin

25
How long should antibiotics be prescribed in tonsillitis?
10 days
26
What antibiotic therapy is used in tonsillitis with penicillin allergy?
10 days of clarithromycin
27
What is the aim of a tonsillectomy?
To reduce recurrence
28
When is a tonsillectomy indicated?
- Recurrent streptococcal tonsillitis - Enlarge tonsils obstructing the airway - Possible malignant disease of tonsils
29
What are the potential complications of tonsillitis?
- Peritonsillar abscess - Acute otitis media - Obstructive sleep apnoea - Streptococcal infection may cause guttate psoriasis