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ENT Year 2 Medicine > Tonsils > Flashcards

Tonsils Flashcards

1
Q

What is the main function of the tonsils?

A

Trap bacteria and expose the antigens to the immune system allowing antibody production. Random environmental sampling.

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2
Q

What is Waldeyers ring?

A

A ring of lymphoid tissue within the sub epithelial layer of the oropharynx.

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3
Q

What lymphoid tissue makes up waldeyers ring?

A

Adenoid Palatine and Lingual tonsils

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4
Q

What do palatine tonsils look like histologically?

A

Specialised squamous cover with deep crypts

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5
Q

What do the adenoid tonsils look like histologically?

A

Ciliated pseudostratified columnar with deep folds.

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6
Q

The majority of acute tonsillitis cases are bacterial? T/F

A

False the vast majority are viral, up to 30% are bacterial.

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7
Q

List some common viral causes of acute tonsilitis

A

EBV
Rhino, Aden, Coronavirus
Influenza
Parainfluenza

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8
Q

If someone presents with chronic tonsilitis what are the common causative pathogens?

A

Strep pyogenes
H.Influenza
S.Aureus
S.Pneumonia

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9
Q

How would someone with a viral acute tonsillitis present?

A 
Malaise
Sore throat
Temperature
Near normal activity 
3-4 days duration
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10
Q

How would someone with a bacterial acute tonsillitis present?

A 
Systemic upset
Fever
Halitosis
Lymphadenopathy
Odynophagia
Unable to work
1 week duration
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11
Q

What is the supportive treatment for someone with acute tonsillitis?

A

Eat Drink Rest NSAIDs

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12
Q

What is the antibiotic treatment used for someone with a severe bacterial tonsillitis?

A

Penicillin 500mg 10 days

Clarythromycin if allergic

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13
Q

If someone is admitted to hospital with acute tonsillitis what is the treatment plan?

A

IV Fluids
IV Antibiotics
IV steroids

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14
Q

In order to undergo a tonsillectomy what criteria must be met?

A

7x Antibiotically treated cases within 1 year.

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15
Q

What risk is there of haemorrhage as a result of a tonsillectomy?

A

5%

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16
Q

How long does the pain post tonsillectomy last and at what day does it peak?

A

Lasts for 7 days and pain is worst on the 5th

17
Q

What is required post operatively for a tonsillectomy and should be taken daily rather than required?

A

Strong Opiates

18
Q

What is a major risk of acute tonsilitis?

A

Peritonsillar abscess

19
Q

What is the clinical presentation of someone with a peritonsillar abscess?

A

Unilateral throat pain and odynophagia
Trismus - limited jaw movement
3-7 days of preceding tonsilitis

20
Q

What is a peritonsillar abscess?

A

Puss formation between the underlying muscle and the tonsil.

21
Q

What will you see in the mouth of someone with a peritonsillar abscess?

A

Medial displacement of the uvula and tonsils

Loss of the palate concave shape.

22
Q

What is the treatment for a peritonsillar abscess?

A

Canula aspiration

Antibiotics

23
Q

What is infectious mononucleosis also called?

A

Glandular fever

24
Q

What is the causative organism behind glandular fever?

A

Epstein Barr Virus

25
Q

What is the clinical presentation of someone with glandular fever?

A

Gross tonsillar enlargement with membranous exudate
Palatial Petechiae
Splenomegally

26
Q

What are Palatial Petechiae?

A

Haemorrhage marks on the roof of the mouth

27
Q

What is required to diagnose glandular fever?

A

Atypical lymphocytes
+ve monospot
Low CRP <100

28
Q

What is important to remember in the treatment of glandular fever?

A

NEVER prescribe Ampicillin or Amoxicillin

Risk of macular rash

29
Q

What is the mainstay of treatment for glandular fever?

A

Systemic treatment

Antibiotics and Steroids

30
Q

What signs indicate a obstructive hyperplasia of the adenoids?

A 
Obligate mouth breather
Hyponasal voice
Snoring
Sleep Disturbances
OME
31
Q

What signs indicate an obstructive hyperplasia of the palatines?

A

Snoring
Sleep Disturbances
Muffled voice
Dysphagia

ENT Year 2 Medicine (12 decks)

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