9: Tonsils Flashcards Preview

ENT Week 2 2017/18 > 9: Tonsils > Flashcards

Flashcards in 9: Tonsils Deck (38)
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1

go back over the 1st half of this

2

What are the symptoms and duration of viral tonsilitis?

Malaisae

Sore throat

Mild fever

Lymphadenopathy

Lasts 3-4 days

3

What are the symptoms and duration of bacterial tonsilitis?

Much more severe:

Systemic upset

Fever

Odynophagia

Halitosis

Lymphadenopathy

Reduced capability to do daily activities

+ 1 week

4

Which criteria are used to decide if a sore throat requires antibiotics?

Centor criteria

5

Which infection is indicated by 4 or 5 Centor points?

GAS infection

6

What does tonsilitis look like?

Inflamed throat

Enlarged tonsils

Exudate

7

What is the supportive treatment for tonsilitis?

Fluids

Rest

Analgesia

8

What antibiotics are given for severe tonsilitis?

For how long?

Penicillin / Clarithromycin

10 days

9

If tonsilitis is to be managed in hospital, what treatments are given?

IV fluids

IV antibiotics

IV steroids

10

If tonsilitis is persistent and recurrent, what is done?

Tonsilectomy

11

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

12

What analgesia is required following tonsillectomy?

Strong opioids e.g morphine

13

What is a local complication of untreated acute tonsilitis?

Peritonsilar abscess / Quinsy

14

What is a peritonsilar abscess?

Stretching of tonsil by pus produced by bacteria

15

What are the symptoms of peritonsillar abscess?

UNILATERAL throat pain, odynophagia

Trismus (lockjaw)

16

What does a peritonsilar abscess look like?

Swelling over tonsil

Uvula deviates away from abscess

17

How is a peritonsilar abscess treated?

Aspiration

Antibiotics

18

Which disease, caused by EBV, produces a severe tonsilitis, lymphadenopathy and hepatosplenomegaly?

Infectious mononucleosis

19

How is glandular fever diagnosed?

Atypical lymphocytes on blood film

Positive antibody test (Monospot or Paul-Bunnell)

20

How is glandular fever treated?

Supportive

NO AMOXICILLIN (amoxicillin causes rash with EBV) - penicillin and steroids PRN

21

Which antibiotic should not be given to someone with tonsilitis?

Amoxicillin

may produce a macular rash

22

What pathology of the tonsils may cause stertor or sleep apnoea?

Hyperplasia of palatine tonsils

23

What pathology of the tonsils may cause otitis media or a hyponasal voice?

Hyperplasia of adenoid tonsils

24

What should your suspicion be if a patient has unilateral tonsilar enlargement?

Neoplasia

25

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

26

In which variant of otitis media is pain, fever and irritability seen?

Acute otitis media

NOT a feature with effusion

27

What group is glue ear common in?

Children

28

(Boys / girls) are more likely to develop glue ear.

Boys

29

What is thought to cause glue ear?

Eustachian tube blockage

30

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

Misbehaviour

School performance is poor

SPEECH AND LANGUAGE DEVELOPMENTAL DELAY