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
What is the clinical presentation of someone with glandular fever?
Gross tonsillar enlargement with membranous exudate Palatial Petechiae Splenomegally
26
What are Palatial Petechiae?
Haemorrhage marks on the roof of the mouth
27
What is required to diagnose glandular fever?
Atypical lymphocytes +ve monospot Low CRP <100
28
What is important to remember in the treatment of glandular fever?
NEVER prescribe Ampicillin or Amoxicillin | Risk of macular rash
29
What is the mainstay of treatment for glandular fever?
Systemic treatment | Antibiotics and Steroids
30
What signs indicate a obstructive hyperplasia of the adenoids?
``` Obligate mouth breather Hyponasal voice Snoring Sleep Disturbances OME ```
31
What signs indicate an obstructive hyperplasia of the palatines?
Snoring Sleep Disturbances Muffled voice Dysphagia