Nose

Question 1

Anterior Epistaxis
-Causes
-MC location
-Treatment

Answer 1

-Nasal trauma (pick nose), dry weather, alcohol, anti platelet meds, cocaine
-Kiesselbach Plexus
-Direct pressure 5-15 minutes leaning forward, topical vasodilators (oxymetazoline)
-Cautery
-Nasal packing

Question 2

Posterior Epistaxis
-Causes
-MC locations
-Treatment

Answer 2

-Hypertension, old age, atherosclerosis
-Sphenopalatine artery and Woodruff Plexus
-Balloon catheter, posterior packing, admit

Question 3

Allergic Rhinitis
-Symptoms
-Cause
-Treatment

Answer 3

-Rhinovirus
-Pale, boggy turbinates, allergic salute, allergic shiner, cobblestone mucosa of conjunctiva, nasal polyps
-Intranasal corticosteroids (Mometasone, Fluticasone)

-Rhinitis Medicamentosa: do not use for more than 3-5 days

Question 4

Nasal Polyps
-Causes
-Treatment
-Samter’s Triad Components

Answer 4

-Allergic Rhinitis and Cystic Fibrosis
-Intranasal glucocorticoids
-Nasal Polyps + Asthma + Aspirin Sensitivity

Question 5

Acute Sinusitis
-Cause if viral
-Cause if bacterial
-Symptoms
-Testing (multiple)
-Treatment
-Chronic?

Answer 5

-Rhinovirus
-Strep Pneumo
-Facial pain with bending or leaning forward, purulent nasal discharge, headache
-CT without contrast, XR (Water’s View), Biopsy is definitive
-Supportive, ABX if > 10 days (Amox, Augmentin) or worsening symptoms
-Chronic > 12 weeks: Staph A MCC

Question 6

Mucormycosis/Zygomycosis
-Definition
-Risk Factors
-Symptoms
-Testing
-Treatment

Answer 6

-Fungal infection of sinusitis that leads to brain and orbit involvement
-Immunocompromised, DM
-Black eschar on palate, face, or nasal mucosa
-Biopsy: non septate broad hyphae with irregular right angle branching
-IV Amphotericin B