Lecture 8 - nasal disease intro (Specht) Flashcards
CS that can help localize dz to the nose
increased inspiratory effort nasal d/c sneezing upper respiratory sounds; stertor (snoring) obligate mouth breathing visible lesions
nasal dz may have increased __ effort
inspiratory
audible nose that localized dz to nose
stertor (snoring)
__ implies that the capacity of mucociliary clearance mechanism has been exceeded
nasal d/c
increased production (acute) decreased clearance (chronic)
common ddx for nasal dz
1 neoplasia 2 NP polyp 3 fungal rhinitis (asper, crytpococcus) 4 feline infectious resp dz (feline URTI); herpes, calic, chlamydiophila, myco 5 FB 6 tooth root abscess 7 allergic/LP or idiopathic rhinitis
younger patient with nasal CS narrows ddx list to
viral/bacterial
polyp
congenital
dysphagic d/o
older patient with nasal CS narrows ddx list to
neoplasia
fungal
allergic/LP rhinitis
dental dz
1 thing to ask about the environment when a patient has suspected nasal dz
SMOKING; common cause of nasal dz in animals
unilateral nasal d/c could suggest
FB
tooth root abscess
neoplasia (uni and bi)
fungus (uni and bi)
bilateral nasal d/c could suggest
rhinitis
bacterial/viral
neoplasia (both)
fungal (both)
review notes on dx testing for nasal dz
LOOK UP
mucoid d/c
mycotic rhinitis
neoplasia
mucopurulent or puruluent nasal d/c
viral/bacterial neoplasia fungal polyp ON fistula more ..
epistaxis
fungal neoplasia hypertension rickettsial dz thrombocytopathy/coagulopathy trauma
t/f: the presence of bacteria in nasal secretions is normal
true
__ may be useful in cases of nasal cryptococcosis for dx and monitoring tx response
serology (ag test)
T/F: a negative titer r/o nasal aspergillus fumigatus
false, does not rule it out!
also an ab titer can support dz but does not confirm it
can nasal radiographs or CT provide a specific dx
no!
can rhinoscopy give a specific dx?
No (except with FB, or mites)
what is the dx test that is most likely to yeild a specific dx if there is a primary nasal dz?
biopsy!
before doing bx of nose get platelet count, PT/PTT, BMBT, BP, and crossmatch bc can bleed profusely
in order to prevent penetration of the calvarium via the cribriform plate when taking nasal Bx what should you do
measure the distance btwn nostril and medial canthus of eye with bx instrument, do not advance further than this distance or will bx brain :0 !
