2.5: Adenotonsillar Disease Flashcards
Function of the adenoids and tonsils?
Trap inhaled bacteria and viruses They present these to immune system to allow antibody production This primes immune system and prevents subsequent infection
What is Waldeyer’s Ring?
A ring of lymphoid tissue in the oropharynx and nasopharynx Contains: - Tonsils (Palatine Tonsil) - Adenoids (Pharyngeal Tonsil) - Lingual Tonsil
Describe the histology of the tonsils?
Stratified Squamous Epithelium (part of the digestive) Deep crypts (also lined with squamous) Lined with lymphoid follicules (immune tissue)
Describe the histology of the adenoids?
Ciliated columnar epithelium (respiratory) They have FOLDS that are squamous epithelium
Differences between tonsils and adenoids - Epithelium - Structures - What system are they part of?
Tonsils: Stratified Squamous Adenoids: Ciliated Columnar Tonsils: Crypts Adenoids: Folds Tonsils: Digestive Adenoids: Respiratory
Common disease of the tonsils and adenoids?
Acute Tonsillitis Recurrent/Chronic Tonsillitis/Adenoidtis Obstructive Hyperplasia Malignancy Tonsil Crypt Debris/Tonsilithis
Describe acute tonsillitis? - Another name - Cause?
Adenotonsillitis - VIral (95%) - Bacterial (5%)
Viral causes of tonsillitis?
Adenovirus Rhinovirus Influenza Parainfluenza Enterovirus EBV (less common but important)
Bacterial causes of tonsillitis - Main and others
Group A Beta Haemolytic Strep Staph Aureus Strep pyogenes
Throat swab in Tonsillitis?
Not helpful Doesn’t show causative organism, just organisms present in mouth
Symptoms of viral tonsillitis?
Malaise Sore throat temperature Can undertake normal activity Some lymphadenopathy
Symptoms of bacterial tonsillitis?
Systemic upset Worse than viral Fever Odynophagia Halitosis (Bad breathe) Unable to carry out normal activity Lymphaednopathy
Differences between viral and bacterial tonsillitis?
Fever (Higher in bacteria) Tonsillar Exudates Tender Cervical Adenopathy No cough
Treatment for - Viral - Bacterial tonsillitis?
No treatment - supportive, mild analgesia Bacterial - Assess using Centor Criteria for antibiotics
Centor Criteria?
44 years = -1 - Fever - Tonsil Exudates - Lymphadenopathy - No cough One point for each of these 0-1 = No antibiotic 2-3= Culture and possible antibiotic 4-5 = Antibiotic
What antibiotic is used in bacterial tonsillitis?
Penicillin (Clarithromycin if allergic)
Surgery in tonsillitis?
Watchful waiting is indicated in children Surgery in adults with: - Recurrent and debilitating - 7 cases in one year - 5 cases every year for 2 years - 3 Cases every year for 3 years