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Junior E.N.T > ACUTE AND CHRONIC SINUSITIS > Flashcards

ACUTE AND CHRONIC SINUSITIS Flashcards

1
Q

_____________ of the _____________ of the ________ and _____________ – rhinosinusitis

A

Inflammation

mucosal lining

nose ; paranasal sinuses

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2
Q

rhinosinusitis
Blocks the _______ and impedes the _____________ from the _______

This usually follows __________

A

ostia

drainage of mucus

sinuses

common cold

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3
Q

Classification: Clinical/ duration

Acute sinusitis: __________
Subacute sinusitis: __________ to __________
Recurrent acute: __________ episodes per year
Chronic sinusitis: __________

A

<4weeks
4weeks to 12 weeks
4 or more episodes
>12weeks

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4
Q

Classification of sinusitis

Cause
_________ or _________

_________: _________/ _________/_________

A

Allergic or Non-allergic

Non-Allergic: Infection/ Inflammatory/Anatomic

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5
Q

SURGICAL ANATOMY
____ pairs of sinuses namely ___________ , ___________, ___________ and ___________.

They open into the ___________ and ___________ ___________ wall of the nose via the _______

A

4

maxillary, ethmoid, frontal and sphenoid.

lateral ; posterior superior

ostia

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6
Q

Surgical anatomy

Lateral wall of the nose have ____ turbinates namely; ___________ , ___________ & ___________

Under each turbinate is a corresponding ___________

A

3

inferior, middle & superior

meatus

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7
Q

Inferior turbinate originate from the ________ while middle and superior originate from the __________

A

maxilla

ethmoid bone

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8
Q

Nasolacrimal duct drains into the __________

A

inferior meatus

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9
Q

The maxillary, anterior ethmoidal and frontal sinuses drains into the _________ also called the _________

The posterior ethmoid and sphenoid sinuses drain into the _________ meatus

A

middle meatus

osteomeatal complex

superior meatus

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10
Q

The _________,_______, and _________ sinuses drains into the middle meatus also called the osteomeatal complex

The _________ and __________ sinuses drain into the superior meatus

A

maxillary, anterior ethmoidal and frontal

posterior ethmoid and sphenoid

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11
Q

Surgical anatomy

Lining- Respiratory ________ epithelium made up of ____ cells namely
- ____________ cells
-____________ cells
-____________ cells
-____________ cells

Attached to the _________ to form _________

A

pseudostratified

4

-Ciliated columnar cells
-Nonciliated columnar cells
-Goblet mucous cells
-Basal cells

periosteum; mucoperiosteum

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12
Q

Physiologic function of sinuses

List 6

A

Phonetic
Respiratory
Olfactory
Static:
Mechanical
Thermal

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13
Q

Physiologic function of sinuses

Phonetic: _________ , protection from —————- of own speech

Respiratory: ______________ , _______ pressure changes, local _____________

Static: Reduce ___________

A

Resonance; bone conduction

Humidification; buffer; immunologic defense

skull weight

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14
Q

Physiologic function of sinuse

Olfactory: Olfactory ________ , ___________ of stimuli
Mechanical: ___________
Thermal: __________

A

mucosa ; air reservoir

Trauma protection

Heat insulation

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15
Q

Pathophysiology

Three major factors are implicated namely:
I) __________________
ii) Dysfunction of __________________
iii) __________________ secretions

A

Narrow sinus ostia

ciliary apparatus

Viscous sinus

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16
Q

Pathophysiology Three major factors are implicated namely:

Narrow sinus ostia from
_________ & ______________

_________ colonization and multiplication

________in the sinus, _______ pressure & secretion __________
ii) Dysfunction of ciliary apparatus
iii) Viscous sinus secretions –impairs ______________

A

inflammation; mechanical obstruction

Bacterial

Hypoxia; negative; retention

ciliary movement

17
Q

Pathophysiology
Disturbed host and microbial factors

-___________ + ______________

-Mucosal oedema and pathology leads to ___________________

-Disturbed cellular metabolism (metabolic acidosis), inflammation and gross mucosal pathology + polyps

  • _______________ of colonized bacteria
A

Immune defence + Mucociliary clearance

reduced ostial patency

Multiplication

18
Q

Etioology

Infectious: ______,______,_______

Local factors: Nasal _________, Choanal _________, ________,_________,_________ , FB, tumours, septal _________, concha ________, ciliary _________

A

Viral, bacteria, fungal

obstruction; atresia

adenoid ; rhinitis ; polyps

deviation; bullosa; dyskinesia

19
Q

Etiology

Systemic factors: _________,_________,__________

Immune deficiencies: _________, organ transplant, _________

Environmental factors: _______ pollution, ___________

A

Asthma, cystic fibrosis, allergic fungal sinusitis

HIV/AIDS; chemotherapy

Air; cigarette smoke

20
Q

Infective Etiology

Infection- viral, bacterial & fungal

Viral causes _______ sinusitis
Types of virus- list 7

Lasts ______________

A

acute

Rhinovirus, Coronavirus, Influenza virus, Adeno virus, Human parainfluenza virus, Human respiratory syncytial virus

7 – 10days

21
Q

Infection Aetiology

Bacterial Causes include

-________________
-________________
-Moraxella catarrhalis
-________________
-________________ bacteria
-Gram negative enteric organisms

A

Streptococcus pneumonia
-Haemophilus influenza

Staphylococcus aureus
-Anaerobic bacteria

22
Q

Infection Aetiology

Fungal causes-

_______,_________

A

Aspergillus, Candida

23
Q

Aetiology

Allergy - _________

Cystic fibrosis- dysfunctional ____________ and ______________

Immunocompromise- ______, ___________

A

Inflammation

ciliary apparatus & viscous secretion

HIV, uncontrolled DM

24
Q

Aetiology

Anatomic variation – ________ septum, _____________ leading to nasal obstruction

Nasal _________ /_________/enlarged _________

A

deviated

concha bullosa

tumour; polyps; adenoid

25
Q

CLINICAL FEATURES
___________ anterior and posterior
Nasal ___________/___________
Facial ___________/___________
Ear ___________/ear ___________
___________
___________ ache

___________

A

Rhinorrhea anterior and posterior
Nasal congestion/obstruction
Facial pain/tenderness
Ear pressure/ear pain
Headache Tooth ache Snoring

26
Q

Clinical features

_________ throat
_________/_________
Cough, which might be worse at _________
_________ (_______)
Fatigue
_________

A

Sore throat
Hyposmia/Anosmia
Cough, which might be worse at night
Bad breath (halitosis)
Fatigue
Fever

27
Q

Factors associated with diagnosis of Rhinosinusitis

Major Symptoms
Facial _____/__________
Facial __________/__________
__________ nasal discharge
__________/__________
Fever
__________ in nasal cavity

A

Facial /pressure
Facial congestion/fullness
Purulent nasal discharge
Hyposmia/anosmia
Fever
Purulence in nasal cavity

28
Q

Factors associated with diagnosis of Rhinosinusitis

Minor symptoms

________
—————
Fatigue
________ pain
Cough
________ pain

A

Headaches
Halitosis
Fatigue
Dental pain
Cough
Ear pain

29
Q

COMPLICATIONS
_________
_________
_________ abscess
_________ sinusitis
_________/ _________
_________ –Pott’s puffy tumour
Orbital _________/_________
Cavernous sinus _________/_________
Otitis media with _________

A

Mucocoel
Meningitis
Brain abscess
Chronic sinusitis
Pharyngitis/ laryngitis
Osteomyelitis –Pott’s puffy tumour Orbital Cellulitis/Ophthalmitis Cavernous sinus thrombosis/Blindness Otitis media with effusion

30
Q

INVESTIGATION

Nasal ______________
_______ of paranasal sinuses
____________ Scan of paranasal sinuses
_______- Intracranial complications
FBC
Swab for ______
________ studies

A

endoscopy

X ray

Computed Tomography

MRI; M/C/S; Allergy

31
Q

TREATMENT
________/_________/___________
Rest
Appropriate antibiotics ___________
topical/oral Steam _________/__________
Antihistamines
Analgesics
Antifungal
__________ spray/ ________ Nasal corticosteroid spray
Surgery endoscopic FESS/ESS

A

Antibiotics/ Glucocorticoids/Surgery

Decongestants

inhalation/humidifier

Saline nasal; irrigation

Junior E.N.T (9 decks)

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