go back over the 1st half of this
What are the symptoms and duration of viral tonsilitis?
Lasts 3-4 days
What are the symptoms and duration of bacterial tonsilitis?
Much more severe:
Reduced capability to do daily activities
+ 1 week
Which criteria are used to decide if a sore throat requires antibiotics?
Which infection is indicated by 4 or 5 Centor points?
What does tonsilitis look like?
What is the supportive treatment for tonsilitis?
What antibiotics are given for severe tonsilitis?
For how long?
Penicillin / Clarithromycin
If tonsilitis is to be managed in hospital, what treatments are given?
If tonsilitis is persistent and recurrent, what is done?
What are the durations of tonsilitis required for tonsilectomy?
Why is this so strictly follow?
7 episodes in one year
5 episodes a year for 2 years
3 episodes a year for 3 years
Surgery is incredibly painful
What analgesia is required following tonsillectomy?
Strong opioids e.g morphine
What is a local complication of untreated acute tonsilitis?
Peritonsilar abscess / Quinsy
What is a peritonsilar abscess?
Stretching of tonsil by pus produced by bacteria
What are the symptoms of peritonsillar abscess?
UNILATERAL throat pain, odynophagia
What does a peritonsilar abscess look like?
Swelling over tonsil
Uvula deviates away from abscess
How is a peritonsilar abscess treated?
Which disease, caused by EBV, produces a severe tonsilitis, lymphadenopathy and hepatosplenomegaly?
How is glandular fever diagnosed?
Atypical lymphocytes on blood film
Positive antibody test (Monospot or Paul-Bunnell)
How is glandular fever treated?
NO AMOXICILLIN (amoxicillin causes rash with EBV) - penicillin and steroids PRN
Which antibiotic should not be given to someone with tonsilitis?
may produce a macular rash
What pathology of the tonsils may cause stertor or sleep apnoea?
Hyperplasia of palatine tonsils
What pathology of the tonsils may cause otitis media or a hyponasal voice?
Hyperplasia of adenoid tonsils
What should your suspicion be if a patient has unilateral tonsilar enlargement?
What is the difference between acute otitis media and glue ear?
OME caused by fluid buildup e.g blockage of Eustachian tube
Both involve acute inflammation of middle ear
In which variant of otitis media is pain, fever and irritability seen?
Acute otitis media
NOT a feature with effusion
What group is glue ear common in?
(Boys / girls) are more likely to develop glue ear.
What is thought to cause glue ear?
Eustachian tube blockage
How does glue ear present in children?
Hearing loss but they won't tell you that
No earache because that's not seen in OME
School performance is poor
SPEECH AND LANGUAGE DEVELOPMENTAL DELAY