Tonsillitis/Pharyngitis Flashcards
Tonsillitis is primarily an infection of which of the following?
1 - adenoid tonsils
2 - palatine tonsils
3 - tubal tonsils
4 - lingual tonsils
2 - palatine tonsils
- located in oropharynx
Can also cause adenoiditis and pharyngitis
What is the incidence of tonsillitis?
1 - 5 in 100,000
2 - 50 in 100,000
3 - 500 in 100,000
4 - 5000 in 100,000
3 - 500 in 100,000
Does tonsillitis affect males or females more?
- equally affected
What age does tonsillitis typically occur?
1 - 1-3 y/o
2 - 1-7 y/o
3 - 6-15 y/o
4 - 10-20 y/o
3 - 6-15 y/o
Is bacterial or viral cause of tonsillitis more common?
- viral
But both can cause them
Virus are the most common cause of tonsillitis. All of the following can cause tonsillitis, but which is the most common?
1 - rhinovirus
2 - coronavirus
3 - parainfluenza
4 - adenovirus (4%)
5 - influenza virus type A and B
6 - herpes simplex virus
7 - epstein-Barr virus (glandular fever)
1 - rhinovirus
Rhinovirus, coronavirus and parainfluenza account for 25% of all causes of tonsillitis
Which of the following bacteria is the most common bacterial cause of tonsillitis?
1 - E. coli
2 - S. aureus
3 - Group A streptococci
4 - Group C streptococci
3 - Group A streptococci
Often referred to as strep throat and causes purulent appearance
Which of the following does not typically occur in the pathophysiology of tonsillitis?
1 - micro-organisms infiltrate palatine tonsils epithelium
2 - B and T cells phagocytes micro-organisms
3 - macrophages present micro-organisms antigens to B and T cells stimulating an immune response
4 - phospholipase A2 (inflammatory cytokines are produced.
5 - pyrexia, oropharyngeal swelling, pain and erythema occur following immune response
2 - B and T cells phagocytes micro-organisms
Macrophages phagocytose the micro-organisms and present the antigens to B and T cells
Patients can have all of the following symptoms in tonsillitis, but which is by far the most common?
1 - coryzal symptoms (nasal congestion, headache, earache, cough).
2 - Fever >38ºC
3 - Dysphagia
4 - Sore throat and refusal of foods
5 - enlarged lymph nodes
4 - Sore throat and refusal of foods
- occurs in 99% of patients
In tonsillitis, is a cough more common if the cause is viral or bacterial?
- viral
If no cough, suspect bacterial cause
In tonsillitis, is a high temperature more common if the cause is viral or bacterial?
- bacterial
In a patient with tonsillitis, which of the following may be visible upon examining the pharynx?
1 - severely inflamed tonsils
2 - enlarged and painful anterior cervical lymph nodes
3 - purulent tonsils
4 - all of the above
4 - all of the above
If there is pus on the tonsils, is this more likely to be bacterial or viral as the cause?
- bacterial
Which of the following patients should NOT have a throat examination in someone presenting with symptoms of tonsillitis?
1 - suspect asthma exacerbation
2 - suspect anaphylaxis
3 - suspect epiglottitis
4 - suspect sepsis
3 - suspect epiglottis
- epiglottis folds over when we swallow, blocking the trachea so we do not aspirate food into the lungs
Suspect epiglottis if a young child, muffled voice and excessive drooling and pooling of saliva.
Call for an anaesthetist and an ENT surgeon.
Is tonsillitis is suspected, is the diagnosis confirmed with testing or is this clinical diagnosis?
- clinical