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ENT Year 2 Medicine > Tonsils > Flashcards

Flashcards in Tonsils Deck (31)
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1

What is the main function of the tonsils?

Trap bacteria and expose the antigens to the immune system allowing antibody production. Random environmental sampling.

2

What is Waldeyers ring?

A ring of lymphoid tissue within the sub epithelial layer of the oropharynx.

3

What lymphoid tissue makes up waldeyers ring?

Adenoid Palatine and Lingual tonsils

4

What do palatine tonsils look like histologically?

Specialised squamous cover with deep crypts

5

What do the adenoid tonsils look like histologically?

Ciliated pseudostratified columnar with deep folds.

6

The majority of acute tonsillitis cases are bacterial? T/F

False the vast majority are viral, up to 30% are bacterial.

7

List some common viral causes of acute tonsilitis

EBV
Rhino, Aden, Coronavirus
Influenza
Parainfluenza

8

If someone presents with chronic tonsilitis what are the common causative pathogens?

Strep pyogenes
H.Influenza
S.Aureus
S.Pneumonia

9

How would someone with a viral acute tonsillitis present?

Malaise
Sore throat
Temperature
Near normal activity
3-4 days duration

10

How would someone with a bacterial acute tonsillitis present?

Systemic upset
Fever
Halitosis
Lymphadenopathy
Odynophagia
Unable to work
1 week duration

11

What is the supportive treatment for someone with acute tonsillitis?

Eat Drink Rest NSAIDs

12

What is the antibiotic treatment used for someone with a severe bacterial tonsillitis?

Penicillin 500mg 10 days
Clarythromycin if allergic

13

If someone is admitted to hospital with acute tonsillitis what is the treatment plan?

IV Fluids
IV Antibiotics
IV steroids

14

In order to undergo a tonsillectomy what criteria must be met?

7x Antibiotically treated cases within 1 year.

15

What risk is there of haemorrhage as a result of a tonsillectomy?

5%

16

How long does the pain post tonsillectomy last and at what day does it peak?

Lasts for 7 days and pain is worst on the 5th

17

What is required post operatively for a tonsillectomy and should be taken daily rather than required?

Strong Opiates

18

What is a major risk of acute tonsilitis?

Peritonsillar abscess

19

What is the clinical presentation of someone with a peritonsillar abscess?

Unilateral throat pain and odynophagia
Trismus - limited jaw movement
3-7 days of preceding tonsilitis

20

What is a peritonsillar abscess?

Puss formation between the underlying muscle and the tonsil.

21

What will you see in the mouth of someone with a peritonsillar abscess?

Medial displacement of the uvula and tonsils
Loss of the palate concave shape.

22

What is the treatment for a peritonsillar abscess?

Canula aspiration
Antibiotics

23

What is infectious mononucleosis also called?

Glandular fever

24

What is the causative organism behind glandular fever?

Epstein Barr Virus

25

What is the clinical presentation of someone with glandular fever?

Gross tonsillar enlargement with membranous exudate
Palatial Petechiae
Splenomegally

26

What are Palatial Petechiae?

Haemorrhage marks on the roof of the mouth

27

What is required to diagnose glandular fever?

Atypical lymphocytes
+ve monospot
Low CRP <100

28

What is important to remember in the treatment of glandular fever?

NEVER prescribe Ampicillin or Amoxicillin
Risk of macular rash

29

What is the mainstay of treatment for glandular fever?

Systemic treatment
Antibiotics and Steroids

30

What signs indicate a obstructive hyperplasia of the adenoids?

Obligate mouth breather
Hyponasal voice
Snoring
Sleep Disturbances
OME