UPSC-CMS 2019 — ENT

Question 1: Regarding "Quinsy" all of the following are correct EXCEPT:

• A. It is an abscess in the peritonsillar region
• B. In early stage, intravenous broad spectrum antibiotics may resolve it
• C. Pus may be seen pointing underneath the thin mucosa in all cases and is diagnostic (Correct Answer)
• D. Severe trismus is caused by spasm induced by pterygoid muscles

Explanation: ***Pus may be seen pointing underneath the thin mucosa in all cases and is diagnostic*** - While **pus** is present in a peritonsillar abscess, it is **not always visibly "pointing"** underneath the mucosa. - The diagnosis of quinsy relies on clinical presentation and physical examination findings like **uvular deviation** and **trismus**, not solely on visible pus pointing. *It is an abscess in the peritonsillar region* - **Quinsy** is indeed an alternative name for a **peritonsillar abscess**, which is a collection of pus located lateral to the tonsil. - This abscess typically forms due to an infection that spreads from the tonsil itself into the surrounding loose connective tissue. *In early stage, intravenous broad spectrum antibiotics may resolve it* - In the initial stages of a **peritonsillar abscess**, before significant pus collection, **intravenous broad-spectrum antibiotics** can sometimes successfully resolve the infection. - This approach aims to reduce inflammation and prevent further progression to a full-blown abscess requiring drainage. *Severe trismus is caused by spasm induced by pterygoid muscles* - **Trismus**, or difficulty opening the mouth, is a characteristic symptom of quinsy and is caused by irritation and **spasm of the pterygoid muscles**. - This muscle spasm occurs due to the close anatomical relationship between the **peritonsillar abscess** and the pterygoid muscles.