Infectious/Allergic Rhinitis and Sinusitis

Question 1

What anatomical structures do we consider Upper Airways?

Answer 1

Nose, Pharynx, and larynx and their related parts.

Question 2

What are the two types of Rhinitis?

Answer 2

Infectious and allergic

Question 3

Top 3 pathogens causing infectious rhinitis and which one is the most common cause of infectious rhinitis?

Answer 3

Rhinovirus (most common), adenovirus, and echovirus

Question 4

Rhinitis is characterized by what and what 3 common symptoms?

Answer 4

Characterized by inflammation of the nasal mucosa. Sneezing, congestion and runny nose.

Question 5

What are two bacterial pathogens that are superimposed bacterial infections?

Answer 5

Strep pneumonia and H influenza

Question 6

What is the cause of allergic rhinitis?

Answer 6

Type 1 hyperactivity IGE mediated reaction against pollen or animals for example.

Question 7

How is allergic rhinitis characterized and what two things is it associated with?

Answer 7

Inflammatory infiltrate of eosinophils.

Asthma and eczema

Question 8

What does recurrent bouts of rhinitis lead to?

Answer 8

Nasal polyps

Question 9

How do we define/characterize a nasal polyp?

Answer 9

Protrusion of edematous mucosa that is infiltrated with eosinophils

Question 10

What can nasal polyps lead to and why?

Answer 10

Superimposed bacterial infection because they block sinus drainage.

Question 11

What is usually preceded by acute rhinitis?

Answer 11

Acute sinusitis

Question 12

When there is impairment of drainage in acute sinusitis, what two things can develop?

Answer 12

Empyema and mucocele

Question 13

If acute sinusitis is not preceded by rhinitis, how does the infection get in?

Answer 13

Usually coming from the oral cavity and into the max sinus through the bony floor of the sinus.

Question 14

What are 3 complications of severe chronic sinusitis?

Answer 14

It can spread. Spread to orbit, surrounding bone, and cranial vault causing thrombophlebitis

Question 15

Explain what patient population was mentioned particularly with sinusitis?

Answer 15

Diabetic patients, being immunocompromised to start out, are at risk for getting sinusitis from the fungus mucormycosis. The pathogen travels from the nasal sinuses to the orbit and brain causing rhinocerebral mucormycosis. This is an emergent situation requiring IV anti fungal so it doesn’t get to the brain.

Question 16

Top 2 complications due to sinusitis spreading from the maxillary sinus?

Answer 16

Osteomyelitis and mucocele

Question 17

Top 3 complications of sinusitis spreading from ethmoid sinus?

Answer 17

Preseptal cellulitis, subperiosteal abscess, and orbital cellulitis

Question 18

Top 4 complications of sinusitis spreading from the frontal sinus?

Answer 18

Meningitis, epidural abscess, mucocele and osteomyelitis

Question 19

What is the one complication of sinusitis spreading from the sphenoid sinus?

Answer 19

Mucocele

Question 20

What fungus can causes allergic fungal sinusitis?

Answer 20

Aspergillus

Question 21

Granulomatosis with Polyangitis affects what age of of patients, how does it present, and what other 2 places in the body can it affect?

Answer 21

Middle aged.
Ulceration, necrosis and perforation of septum.
Lungs and kidneys

Question 22

2 hallmarks of histology for GPA?

Answer 22

Granulomatous inflammation

Blue necrosis which is called necrobiotic