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ENT Week 2 2017/18 > 8: Stuffy nose > Flashcards

8: Stuffy nose Flashcards

1
Q

Which cytokines are released by mast cells after IgE causes their degranulation?

A

Histamine

Leukotrienes (interleukins)

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2
Q

What are some examples of

a) topical corticosteroids
b) anti-histamines
c) anti-cholinergics
d) decongestants

used in allergic rhinitis?

A

a) Beclometasone

b) Cetirizine

c) Ipratropium

d) Pseudoephedrine

Also: montelukast

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3
Q

What are the four core nasal symptoms?

A

Blocked nose

Discharge

Loss of smell

Facial pain

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4
Q

What are the 4 Ss of nasal symptoms?

A

Stuffy

Snot

Smell

Sore

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5
Q

What symptoms are seen in allergic nose disease?

A

Sneezing

Itch

Crusting

Epistaxis

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6
Q

What are the three steps of a nasal examination?

A

Examine airway patency

Examine external nose

Rhinoscopy

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7
Q

What should you ask the patient to do when you stick a scope up their nose?

A

Stop breathing

so the lens isn’t steamed up

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8
Q

What is another name for a nasal concha?

A

Turbinate

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9
Q

Rhinitis can be either ___ or ___.

A

infective

non-infective

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10
Q

What infection commonly results in infectious rhinitis?

A

URTI

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11
Q

Non-infectious rhinitis is further divided into ___ and ___ rhinitis.

A

allergic

non-allergic

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12
Q

What are some associated symptoms that come along with allergic rhinitis?

A

Sneezing

Itch

Crusty eyes

Watery eyes

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13
Q

What allergens cause allergic rhinitis?

A

Pollen

Dust mites

Pet hair

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14
Q

What are the two timings of allergic rhinitis?

A

Intermittent

Persistent

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15
Q

Persistent allergic rhinitis tends to be caused by allergens in your ___.

A

home

dust mites, cat and dog hair

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16
Q

What terms are used to describe the severity of allergic rhinitis?

A

Mild

Moderate/Severe

17
Q

How allergic rhinitis is treated depends on its ___ and ___.

A

timing - intermittent or persistent

severity - mild or severe

18
Q

Which antibody mediates allergic disease?

A

IgE

19
Q

What is the mainstay for relieving symptoms of allergic rhinitis?

A

Allergen avoidance

20
Q

Which drugs are used to treat allergic rhinitis?

A

Oral antihistamines

Inhaled steroids

+/- cromones, interleukin antagonists

Immunotherapy

21
Q

What experimental treatment can be done to reduce a patient’s sensitivity to allergens?

A

Immunotherapy

22
Q

Why would surgery be indicated for allergic rhinitis?

A

Chronic inflammation leading to fibrosis and loss of airway function

23
Q

What nose lesions are seen alongside non-allergic rhinitis?

A

Nasal polyps

24
Q

How may nasal polyps be treated if they are causing airway problems?

A

Oral steroids

then Topical steroids

then Surgery

25
Q

What are the symptoms of infectious rhinosinusitis?

A

Blocked nose

Discharge - yellow/green

Facial pain

26
Q

What causes the vast majority of infectious rhinosinusitis?

A

Viruses

27
Q

How is infectious rhinosinusitis treated?

A

Supportive - analgesia and decongestion

Add antibiotic if persistent

28
Q

What are some serious complications of infectious rhinosinusitis?

A

Cavernous sinus compression

Orbital cellulitis

Meningitis

Rheumatic fever

29
Q

How is non-allergic, non-infective rhinitis treated?

A

Anti-muscarinics e.g ipratropium

30
Q

How is allergic rhinitis investigated?

A

Skin PRICK test (Type I hypersensitivity)

RAST (picks up specific IgE levels)

31
Q

Which type of imaging isn’t helpful in allergic rhinits?

A

Nasal / Sinus X-rays

32
Q

What are some possible triggers for non-allergic rhinitis?

A

Drugs

Alcohol

33
Q

How is non-allergic rhinitis managed?

A

Topical steroid

Antihistamines

Topical anticholinergic for vasomotor rhinitis

34
Q

How is infectious rhinitis managed?

A

Analgesia

Decongestants

+/- Topical antibiotic

35
Q

What can form between the cartilage and bone/soft tissue of the ear/nose in trauma?

A

Haematoma

Collapse due to necrosis (perichondrium raised off its blood supply)

36
Q

What surgery can be done to repair a fractured nose?

A

Rhinoplasty

37
Q

What type of symptom should make you seriously concerned?

A

Unilateral

refer them

38
Q

(Bilateral / unilateral) symptoms should give you serious cause for concern.

A

Unilateral

ENT Week 2 2017/18 (10 decks)

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