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FINALS - ENT > nose > Flashcards

nose Flashcards

1
Q

what organism can causes sinusitis

A

strep pneumo // H. influ // rhinovirus

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2
Q

RF developing sinusitis

A

nasal obstruction eg deviation, polyp // local infection eg rhinits, dental extraction // swimming or diving // smoking

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3
Q

symptoms sinusitis

A

facial pain/ pressure worse bending forward!! // thick nasal discharge // obstruction

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4
Q

mx sinusitis

A

analgesia +/- nasal decongestants or saline

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5
Q

mx sinusitis lasting 10+ days

A

intranasal steroids

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6
Q

abx for sinusitis

A

only if severe/ systemically unwell - may worsen a viral infection // 1 = pen V // 2 = co-amox if v unwell

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7
Q

complication sinusitis

A

brain abscess // orbital abscess

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8
Q

what is seasonal allergic rhinits

A

comes with the seasons secondary to pollen - hayfever

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9
Q

what is perennial allergic rhinits

A

throughout the year

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10
Q

what is occupation allergic rhinits

A

antigens in a work place

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11
Q

mx mild-moderate allergic rhinitis

A

oral/ nasal antihistamine

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12
Q

mx moderate-severe allergic rhinitis

A

intranasal steroids

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13
Q

what can be prescribed for allergic rhinitis to control symptoms prophylactically

A

oral steroids

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14
Q

role of nasal decongestants allergic rhinitis

A

short periods of time // prolonged = require increasing dose + causes rebound hypertrophy on withdrawal

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15
Q

what is vasomotor rhinitis

A

(non-allergic rhinitis) when blood vessels in nose dilate –> runny nose, nose drip

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16
Q

triggers vasomotor rhinitis

A

strong smell, cold air, alcohol, spicy food

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17
Q

what is chronic rhino-sinusitis

A

inflamm disorder of paranasal sinus linings + nasal passage that lasts 12+ weeks

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18
Q

RF chronic rhino-sinusitis

A

atopy // obstruction (deviation or polyp) // local infection // swimming, diving // smoking

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19
Q

symptoms chronic rhino-sinusitis

A

frontal pressure pain worse leaning forward // nasal discharge (clear) // mouth obstruction (from nasal obstruction) // post nasal drip +/- chronic cough

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20
Q

mx chronic sinusitis

A

allergy avoidance // intranasal steroids // nasal irrigation + saline

21
Q

Red flags chronic rhino-sinusitis

A

unilateral!! // persistant after 3 months // epistaxis

22
Q

what causes nasolacrimal duct obstruction

A

incomplete membrane lower end of lacrimal duct

23
Q

symptoms + age nasolacrimal duct obstruction

A

infants + watery eye

24
Q

mx nasolacrimal duct obstruction

A

massage lacrimal duct // if 1 year refer to ophthalmologist

25
Q

assoc nasal polyps

A

asthma // aspirin sensitivity // sinusitis // CF // EGPA (Churg-Strauss) // Kartageners

26
Q

what is samters triad

A

asthma + aspirin sensitivity + nasal polyps

27
Q

features nasal polyps

A

nasal obstruction // runny nose // sneezing // decreased taste + smell

28
Q

what symptoms require further testing in nasal polyps

A

unilateral or bleeding

29
Q

mx nasal polyps

A

refer ENT // topical steroids

30
Q

most common nasopharnygeal cancer

A

SCC

31
Q

what virus is nasopharnygeal cancer assoc with

A

EBV

32
Q

symptoms nasopharnygeal

A

sore ear // unilateral otitis media + effusion // nasal obstruction, discharge, nose bleed // cranial nerve palsy (esp III-VI) // cervical lymph (bad)

33
Q

invx nasopharnygeal cancer

A

CT + MRI

34
Q

mx nasopharnygeal cancr

A

radiotherapy

35
Q

source of bleeding anterior nose bleed

A

kisselbach plexus (esp sphenopalatine)

36
Q

RF assoc with posterior epistaxis

A

aspiration or airway compromise

37
Q

RF epistaxis

A

nose picking or blowing // trauma // bleeding disorder // juvenile angiofibroma // cocaine use // E+GPA // hereditary haemorrhagic telangiectasia

38
Q

first aid mx nosebleed

A

sit forward, mouth open // pinch soft cartilage for 20 mons

39
Q

potential nosebleed mx if first aid successful

A

topical antiseptic eg naseptin (chlorehexidine + neomycin) // avoid blowing nose, heaving lifting, alcohol

40
Q

cautions naseptin

A

peanut, soy, neomycin allergy

41
Q

mx nosebleed that does not stop after 15 mins

A

cautery (usually best) or packing

42
Q

what is nasal cautery

A

apply topical anaesthetic // use silver nitrate // dab clean and apply naseptin or muciprocin // (not well tolerated in kids)

43
Q

when is nasal packing indicated

A

bleeding vessel cannot be visualised

44
Q

emergency epistaxis mx

A

sphenopalatine ligation

45
Q

who needs admitted with epistaxis

A

severe comorbidity (ACS, hypertension) // under 2 (haemphilia, leukaemia) // haemodynamically unstable // unknown source eg posterior bleed

46
Q

symptoms septal heamatoma

A

following trauma // obstruction // pain // runny nose // bilateral, red swelling

47
Q

mx nasal septal heamatoma

A

surgical drainage + IV abx

48
Q

complications septal heamatoma

A

septal necrosis

FINALS - ENT (9 decks)

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