Tonsillitis

Question 1

What is tonsillitis?

Answer 1

inflammation of the tonsils in the throat.

Question 2

What are the two types of tonsillitis?

Answer 2

1. Acute
2. Chronic

Question 3

What is the incidence rate of acute tonsillitis?

Answer 3

A general practitioner (GP) typically sees around 120 people in a 2,000-patient population with an acute sore throat every year.

Question 4

What is the incidence rate of chronic tonsillitis?

Answer 4

chronic tonsillitis generally has an incidence of 100 per 1,000-patient population in the UK

Question 5

What age demographic has the highest incidence rate?

Answer 5

children and young adults, aged 5 to 24 years old, have the highest incidence, representing 50% of total cases

Question 6

What is the ring-shaped lymphoid tissue on the oropharynx?

Answer 6

Waldeyer’s ring

Question 7

How many groups of tonsils are there in the waldeyer’s ring?

Answer 7

4

Question 8

What are the 4 main groups of tonsils called?

Answer 8

1. Adenoid
2. Tubal
3. Palatine
4. Lingual

Question 9

What are the 3 types of infection that can cause tonsillitis?

Answer 9

1. Viral
2. Bacterial
3. Non-infectious

Question 10

What are the most common viral causes of tonsillitis?

Answer 10

1. Rhinovirus (most common)
2. Coronavirus
3. Parainfluenza
4. Epstein Barr Virus (EBV)

Question 11

What are the most common bacterial causes of tonsillitis?

Answer 11

1. Group A beta-haemolytic Streptococcus (GABHS; most common)
2. Haemophilus influenzae
3. Moraxella catarrhalis

Question 12

What are some non-infectious causes of tonsillitis?

Answer 12

1. Gastro-oesophageal reflux disease
2. irritation (e.g. from nasogastric tubes

Question 13

What are the typical symptoms of tonsillitis?

Answer 13

1. Sore throat
2. Cough
3. Coryzal prodrome
4. Dysphonia
5. Pyrexia
6. Pain and malaise

Question 14

What are 2 less common symptoms of tonsillitis?

Answer 14

1. Dysphagia
2. Halitosis

Question 15

Upon examination, what are the typical clinical findings of tonsillitis?

Answer 15

1. Fever
2. Swollen erythematous palatine tonsils
3. Cervical lymphadenopathy
4. Tonsils covered with exudate

Question 16

What is a less common finding of tonsillitis?

Answer 16

Peritonsillar abscess (usually a complication of acute tonsillitis)

Question 17

What is a Peritonsillar abscess?

Answer 17

unilateral bulge above tonsils, accompanied by symptoms such as a sore throat, dysphagia, trismus and a classical hot potato voice.

Question 18

What are the 3 differential diagnosis’ for tonsillitis?

Answer 18

1. Epiglottis
2. Infection mononucleosis (glandular fever) due to Epstein Barr Virus
3. Squamous cell carcinoma

Question 19

What are 4 features differentiating epiglottitis from tonsillitis?

Answer 19

Acute and severe onset
Muffled voice
Drooling
Stridor

Question 20

What are 4 features differentiating glandular fever from tonsillitis?

Answer 20

Pharyngitis of longer duration
Splenomegaly
FBC – raised WBC count with lymphocytosis
Positive Monospot test (in patients > 4 years old)

Question 21

What are 3 features differentiating squamous cell carcinoma from tonsillitis?

Answer 21

Unilateral tonsillar enlargement
Dysphonia
Ulcers