Tonsils and adenoids

Question 1

What tonsils comprise Waldeyer’s ring?

Answer 1

Question 2

What type of epithelium lines which parts of the URT?

Answer 2

Squamous epithelium- where food goes/ high use/ trauma

pharynx, oral cavity, vocal cords, oesophagus

ciliated columnar respiratory epithelium- where air goes

larynx, nose, trachea, pns

Question 3

What causes the majority of tonsilitis cases?

Answer 3

Majority of causes are viral

EBV

parainfluenza

influenza

Rhinovirus

adenovirus

5-30% are,bacterial with strep pyogenes being an important consideration

Swab not recommended because many pathogens exist normally as part of the flora

Question 4

What are the differences between viral and bacterial tonsilitis?

Answer 4

Bacterial tonsilitis lasts longer and has more severe symptoms

Question 5

What is the treatment of tonsilitis?

Answer 5

Supportive

Rest/ food/ drink/ paracetamol/ NSAIDs

Antibiotics

penecillin qid

or

clarythromycin

hospital

iv fluids/ antibiotics

steroids

surgery

Question 6

Signs of glandular fever

Answer 6

Swollen lymph nodes

petechiae on palate

engorged tonsils and exudate from mucosa

Hepatosplenomegaly

Question 7

Diagnosis of EBV

Answer 7

Over 20% of lymphocytes are atypical

monospot or Paul-Bunnell test positive

heterophile antibodies agglutinate horse/ sheep red blood cells

Question 8

What antibiotics should you not give to someone suffering from EBV?

Answer 8

Amoxicillin

ampicillin

Question 9

What’s the difference between aom and ome?

Answer 9

AOM- no hearing loss, no fluid (maybe present)

fever, earache, irritability

OME- hearing loss and fluid

Question 11

Management of aom

Answer 11

Watchful waiting

if recurrent

grommet for under 3 or first time treatment

over 3 or second intervention- grommet and adenoidectomy