tonsils

Question 1

what often causes tonsilitis

Answer 1

group a streps eg strep pyogenes

Question 2

DDX tonsilitis

Answer 2

ebv, agranulocytosis, scarlet fever, leukaemia

Question 3

complications of tonsilitis

Answer 3

retropharyngeal abscess- rare. peritonsillar abscess (quinsy); paraphyrngeal and hypopharyngeal abscesses, Lemierres syndrome

Question 4

what is the typical presentation of a retropharyngeal abscess

Answer 4

ill child with stiff extended neck who fails to eat or drink

Question 5

quinsy signs

Answer 5

sore throat, dysphagia, peritonsillar bulge, uvular deviation, trismus, muffled voice

Question 6

treat quinsy

Answer 6

antibiotics and aspiration. steroids

Question 7

what is Lemierres syndrome

Answer 7

pharyrgotonsillitis, internal jugular vein thrombophlebitis and septic emboli. need high dose benzylpen, clindamycin and metronidazole

Question 8

differentials of an unilateral tonsillar enlargement

Answer 8

true asymmetry, apparent enlargement, tumours- squamous cancer (elderly patient)

Question 9

scarlet fever symptoms

Answer 9

rash on chest, axilla,, behind ears, 12-48h after initial infection. Pastia lines and strawberry tongue

Question 10

treatment scarlet fever

Answer 10

penicillin

Question 11

indications tonsillectomy

Answer 11

5 or more episodes sore throat per year, symptoms for at least a year, resp obstruction, suspicion of malignancy