Module 3 - Runny Nose

Question 1

• allergic rhinitis

Answer 1

pale nasal turbinates
can have cobble stoning in posterial pharynx

Question 2

• treatment for allergic rhinitis

Answer 2

mild
1st line: oral second gen or intranasal antihistamines

mod-sev or persistent
1st line: intranasal steroids (becomethasone)

IF first line INS does not work
- add INA
- do not add oral antihistamines

IF first line oral antihistamine does not work
- add decongestant

IF first like INA does not work
- add INS

Question 3

• treatment for allergic rhinitis

Answer 3

mild
1st line: oral second gen or intranasal antihistamines

mod-sev or persistent
1st line: intranasal steroids (becomethasone)

IF first line INS does not work
- add INA
- do not add oral antihistamines

IF first line oral antihistamine does not work
- add decongestant

IF first like INA does not work
- add INS

Question 4

case study
25yo, runny nose x 4 days, sneezing, clear drainage and now it is thick, low grade fever, sore throat, slight headache

Answer 4

common cold

Question 5

case study
runny and stuffy nose x 2 weeks. persistent postnatal drip and a stuffy and runny nose with thick gray discharge. headache, facial pain, sore throat from drip, low grade fever. now with cough no cp ct
hx of allergies

Answer 5

sinusitis

Question 6

• S/S sinusitis

Answer 6

inflammation of the mucous membranes lining one or more of the paranasal sinuses

• recent respiratory URI with some improvement then relapse
• mucopurulent secretions in nasal passages
• facial tightness, facial pressure/pain
• cold sx longer than 10 days with worsening past day 7
• nasal stuffiness

Question 7

• DIfference in sinusitis vs acute viral rhinosinusitis

Answer 7

AVRS
partial or complete sx resolution in 7-10 days
peak in severity between day 3 and 6
fever first 24-48 hrs
purulent drainage (sign of inflammation of nasal mucosa)
clear purulent clear

Question 8

• Predictors of Acute bacterial rhinosinusitis

Answer 8

1. maxillary tooth ache
2. abnormal transillumination
3. poor response to decontestant
4. purulent drainage
5. hx of colored nasal discharge

Question 9

• treatment of abrs

Answer 9

PNA primary prevention

pathogens
strep pna
h influenza (smoking)
moraxella (DM)

NOSE AND EAR IS SAME (makes sense)

Treatment
amoxicillin
augmentin
PCN: doxy

dont use macrolides (only preggos)