ENT- nose diseases Flashcards
what is acute sinusitis
symptomatic inflammation of the paranasal sinuses, followed by viral resp tract infection, symptoms lasting less than 12 weeks
most common organisms causing acute sinusitis
strep penumoniae
H.influenza
Moraxella catarrhalis
symptoms of acute sinusitis
nasal blockage/discharge
facial pain/pressure (or headache)
< sense of smell
predisposing factors of chronic sinusitis
atopy
nasal obstruction
recent local infection
swimming/diving
smoking
which type of hypersensitivity reaction is allergic rhinitis
type I hypersensitivity
which antibiotics are used first and second line to treat severe/deteriorating cases of acute sinusitis >10 days duration
phenoxymethylpencillin first line
doxycycline second line
red flag symptoms of chronic sinusitis
unilateral symptoms
Persistent symptoms despite compliance with 3 months of treatment
epistaxis (nosebleed)
allergic rhinitis is an IgE-mediated allergic reaction which results in the generation of what
histamine and leukotrienes
symptoms of allergic rhinitis
sneezing
nasal itching
nasal discharge
nasal congestion
what is the medical management of allergic rhinitis
- antihistamines
- topical corticosteroids
- topical steroids and antihistamine
what is the first line treatment for mild symptoms of allergic rhinitis
oral antihistamine
what is the first line treatment for moderate/severe symptoms of allergic rhinitis
intranasal corticosteroids
what is non-allergic rhinitis
inflammation of the inside of the nose that is not caused by an allergy
triggers of vasomotor rhinitis
chemical irritants
changes in weather
excess humidity
very dry atmosphere
stress
causes of non-allergic rhinitis
infection- usually viral
vasomotor- parasympathetic overdrive
occupational rhinitis
hormonal rhinitis- pregnancy, COCP
drug induced rhinitis- acei, b blockers
drugs causing non-allergic rhinitis
ACE inhibitors
beta blockers
NSAIDs
coccaine
complications of non-allergic rhinitis
sinusitis
nasal polyps
what are nasal polyps
soft, painless, noncancerous growths on the lining of the nasal passages
what are nasal polyps often associated with
non-allergic asthma
causes of nasal polyps
non-allergic asthma
allergy
infection
aspirin sensitivity
nickel exposure
if young person has nasal polyps- consider what?
cystic fibrosis
what investigation is used to diagnose nasal polyps
nasoendoscopy
how do you treat nasal polyps
oral then topical steroids
if polyps large/unresponsive- surgery
what is the most common malignant tumour of the nose
squamous cell carcinoma
what is subglottic stenosis
narrowing of the airway below the vocal cords (subglottis) and above the trachea
in adults, what has subglottic stenosis been seen in association with
vasculitis
how does subglottic stenosis present
progressive breathing difficulty, often exacerbated by exertion
