ENT- nose diseases

Question 1

what is acute sinusitis

Answer 1

symptomatic inflammation of the paranasal sinuses, followed by viral resp tract infection, symptoms lasting less than 12 weeks

Question 2

most common organisms causing acute sinusitis

Answer 2

strep penumoniae
H.influenza
Moraxella catarrhalis

Question 3

symptoms of acute sinusitis

Answer 3

nasal blockage/discharge
facial pain/pressure (or headache)
< sense of smell

Question 4

predisposing factors of chronic sinusitis

Answer 4

atopy
nasal obstruction
recent local infection
swimming/diving
smoking

Question 5

which type of hypersensitivity reaction is allergic rhinitis

Answer 5

type I hypersensitivity

Question 6

which antibiotics are used first and second line to treat severe/deteriorating cases of acute sinusitis >10 days duration

Answer 6

phenoxymethylpencillin first line
doxycycline second line

Question 7

red flag symptoms of chronic sinusitis

Answer 7

unilateral symptoms
Persistent symptoms despite compliance with 3 months of treatment
epistaxis (nosebleed)

Question 8

allergic rhinitis is an IgE-mediated allergic reaction which results in the generation of what

Answer 8

histamine and leukotrienes

Question 9

symptoms of allergic rhinitis

Answer 9

sneezing
nasal itching
nasal discharge
nasal congestion

Question 10

what is the medical management of allergic rhinitis

Answer 10

1. antihistamines
2. topical corticosteroids
3. topical steroids and antihistamine

Question 11

what is the first line treatment for mild symptoms of allergic rhinitis

Answer 11

oral antihistamine

Question 12

what is the first line treatment for moderate/severe symptoms of allergic rhinitis

Answer 12

intranasal corticosteroids

Question 13

what is non-allergic rhinitis

Answer 13

inflammation of the inside of the nose that is not caused by an allergy

Question 14

triggers of vasomotor rhinitis

Answer 14

chemical irritants
changes in weather
excess humidity
very dry atmosphere
stress

Question 15

causes of non-allergic rhinitis

Answer 15

infection- usually viral
vasomotor- parasympathetic overdrive
occupational rhinitis
hormonal rhinitis- pregnancy, COCP
drug induced rhinitis- acei, b blockers

Question 16

drugs causing non-allergic rhinitis

Answer 16

ACE inhibitors
beta blockers
NSAIDs
coccaine

Question 17

complications of non-allergic rhinitis

Answer 17

sinusitis
nasal polyps

Question 18

what are nasal polyps

Answer 18

soft, painless, noncancerous growths on the lining of the nasal passages

Question 19

what are nasal polyps often associated with

Answer 19

non-allergic asthma

Question 20

causes of nasal polyps

Answer 20

non-allergic asthma
allergy
infection
aspirin sensitivity
nickel exposure

Question 21

if young person has nasal polyps- consider what?

Answer 21

cystic fibrosis

Question 22

what investigation is used to diagnose nasal polyps

Answer 22

nasoendoscopy

Question 23

how do you treat nasal polyps

Answer 23

oral then topical steroids
if polyps large/unresponsive- surgery

Question 24

what is the most common malignant tumour of the nose

Answer 24

squamous cell carcinoma

Question 25

what is subglottic stenosis

Answer 25

narrowing of the airway below the vocal cords (subglottis) and above the trachea

Question 26

in adults, what has subglottic stenosis been seen in association with

Answer 26

vasculitis

Question 27

how does subglottic stenosis present

Answer 27

progressive breathing difficulty, often exacerbated by exertion