Nasal presentations Flashcards
Name some intermittent causes of allergic rhinitis?
Grass pollen
Tree pollen
Fungal spores
Name some persistent causes of allergic rhinitis?
House dust mite
Cats / dogs
What is the classification for intermittent rhinitis?
Symptoms <4 days a week
OR
Symptoms for <4 weeks
What is the classification for persistent rhinitis?
Symptoms >4 days a week
AND
Duration >4 weeks
What is the classification for mild rhinitis?
Normal sleep
No impairment of daily activity
Normal work / school
What is the classification of moderate-severe rhinitis?
Abnormal sleep
Impairment of daily activity
Missing work / school
Troublesome symptoms
What is the stepwise treatment approach for allergic rhinitis?
Allergen avoidance in all cases
Antihistamines
Topical steroids
Topical steroids + antihistamines
When is immunotherapy used in patients with nasal issues?
In selected patients with IgE mediated disease
What are nasal polyps associated with?
Non-allergic asthma
How should nasal polyps be managed?
Oral steroids
Topical steroids
Surgery can be done if the above is ineffective
What are the symptoms of acute infective rhinosinusitis?
Facial pain
Nasal blockage
Nasal discharge
How should acute infective rhinosinusitis be managed?
Nasal decongestants and analgesia
If persistent / worsening then add an antibiotic
What investigations should not be done for rhinitis presentations?
Nasal x-rays
Sinus x-rays
What is the stepwise treatment approach for non-infective rhinitis?
Topical nasal steroid
+/- Antihistamine
Topical anticholinergic
What are some common nasal traumas?
Septal haematoma
Nasal bone fractures
Nasal cartilage dislocation
Rhinoplasty
What can unilateral nasal discharge suggest in a child?
Foreign body in the nose
Urgent referral
What does unilateral discharge in adults suggest?
Nasal / paranasal tumour
Urgent referral
What complication of acute sinusitis requires an emergency referral?
Orbital cellulitis
