Acute Sinusitis

Question 1

What is sinusitis?

Answer 1

Inflammation of the paranasal sinuses

Question 2

What is sinusitis triggered by?

Answer 2

Viral Upper Respiratory Tract Infection(URTI)

Question 3

How does sinusitis spread within the nose?

Answer 3

It spreads from the nasal cavity into the sinuses

Question 4

Which part of the nose becomes inflamed during sinusitis?

Answer 4

Lining of the nasal cavity

Question 5

If the lining of the nasal cavity is inflamed, what happens to the mucous?

What would normally happen

Answer 5

The mucous which would normally flow through the narrow channels to drain into the nose would be blocked

Question 6

What effect does a blockage of mucous (lack of drainage) have on the sinuses?

Answer 6

Creates pressure and pain

Question 7

What is followed by the primary infection of sinusitis?

Answer 7

Bacterial Secondary infection

Question 8

How common is a secondary bacterial infection following sinusitis?

Answer 8

2 in 100 cases

Question 9

What symptoms are presented during sinusitis?

Answer 9

-Pain and tenderness affecting sinuses
-Throbbing pain which often gets worse when bending forwards
-Green/yellow discharge from the nose
-Headache
-Blocked nose
-Loss of smell
-Fever

Question 10

How long does it take for symptoms of sinusitis to improve?

Answer 10

7-10 days

Question 11

How long does it take for symptoms of sinusitis to resolve?

Answer 11

2-3 weeks, but may take as long as 12 weeks

Question 12

What age group is sinusitis more prevalent in?

Answer 12

Can occur in any age group but is more common in children

Question 13

Why is sinusitis more common in children?

Answer 13

Their sinuses have not yet fully developed

Question 14

What advice should you give patients with symptoms of sinusitis for 10 days or less?

Answer 14

Antibiotics unlikely to be appropriate

Question 15

Why are antibiotics inappropriate for sinusitis?

Answer 15

The are inappropriate because of the likely cause of infection and the expected timeframe

Question 16

Is sinusitis more likely to be viral or bacterial?

Answer 16

Viral

Question 17

Is sinusitis self-limiting

Answer 17

Yes, both viral and bacterial are

Question 18

Should analgesia be provided for sinusitis?

Answer 18

Yes

Question 19

What is analgesia?

Answer 19

Used to manage pain and fever

Question 20

Which analgesia should be provided?

Answer 20

Paracetamol or Ibuprofen

Question 21

What can be done about the congestion associated with sinusitis?

Answer 21

-Saline nasal drops
-Xylometazoline
-Pseudoephedrine
-Steam inhalation

Question 22

What is Xylometazoline?

Answer 22

A decongestant nasal spray

Question 23

How long can xylometazoline be used for in the treatment of sinusitis?

Answer 23

7 days

Question 24

Why shouldn’t xylometazoline be used for more than 7 days?

Answer 24

Rebound congestion

Question 25

What is Pseudoephedrine?

Answer 25

A decongestant tablet or component in other formulations

Question 26

Caution should be taken when dispensing pseudoephedrine to patients with which underlying conditions?

Answer 26

Glaucoma and hypertension

Question 27

What is the legal maximum pseudoephedrine that can be dispensed in one transaction?

Answer 27

720mg per transaction

Question 28

What should be prescribed if the patient has had sinusitis for more than 10 days?

Answer 28

Consider prescribing a high dose nasal corticosteroid spray

Question 29

How long should the high-dose nasal corticosteroid spray for treating chronic sinusitis be prescribed for?

Answer 29

14 days

Question 30

What should be considered if sinusitis symptoms persist for more than 10 days?

Answer 30

Dental Infection

Question 31

Should a backup antibiotic prescription be dispensed for chronic sinusitis?

Answer 31

Yes, it is to be used if symptoms do not improve within 7 days or worsen suddenly or significantly

Question 32

What safety netting advice should you give a patient with sinusitis?

Answer 32

The patient should return to seek medical advice if: -Symptoms worsen suddenly or significantly -Symptoms do not improve within 3-5 days of initial treatment -They cannot tolerate the antibiotic (if prescribed) -Becomes systemically unwell

Question 33

Red flag management of sinusitis

Answer 33

-Chronic or recurring sinusitis -Medical conditions such as nasal polyps, which could complicate treatment -Experience repeated treatment failures