Nose and Sinus Flashcards

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1
Q

immune mediated response of nasal mucosa to previously sensitized allergen

A

allergic rhinitis

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2
Q

the genetic predisposition to develop allergic diseases

A

atopy

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3
Q

risk factors of allergic rhinitis (6)

A
  1. family hx
  2. male
  3. birth during pollen season
  4. firstborn
  5. early ABX use
  6. maternal smoking
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4
Q

“boggy/ Pale mucosa”

A

allergic rhinitis

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5
Q

high arched palate from mouth breathing; “cobblestoning”

A

allergic rhinitis

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6
Q

allergic rhinits can be dx

A

clinically–suggestive clinical hx + risk factors

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7
Q

gold standard for dx allergies (3)

A

allergy test:

  1. skin prick
  2. intradermal
  3. skin patch
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8
Q

allergic rhinitis tx (5)

*best

A
  1. allergen avoidance
  2. intranasal corticosteroids *
  3. oral/ intranasal antihistamines *
  4. decongestants
  5. immunotherapy
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9
Q

allergic rhinitis may be

A
  1. intermittent-no troublesome symp

2. persistent- abnormal sleep, work, school–^ symptoms

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10
Q

A polyp presents in the nasal cavity w/ a grape-like appearance, having a ‘body’ and a ‘stalk’. The surface is smooth and the color is more YELLOW than the PINK mucous membrane. Is usually SEMITRANSLUCENT

A

Nasal polyposis

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11
Q
  • a triad of nasal polyposis, aspirin sensitivity, and asthama
A

The aspirin (Samter’s) triad

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12
Q

mucous gland hyperplasticity w/ eosinophilic accumulation due to inflammatory mediators

A

Pathophysiology of nasal polyposis

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13
Q

> 80 of people w/ _____ _____ ______ have polyps

A

Allergic fungal rhinosinusitis

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14
Q

PE of nasal polyposis

A
  1. congestion
  2. polyp
  3. rhinorrhea
  4. “cobblestoning”
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15
Q

dx of nasal polyposis (3)

A
  1. nasal endoscopy

2. CT/MRI

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16
Q

Nasal polyposis tx

A
  1. NASAL STEROID (oral/spray)
  2. surgery
  3. desensitization (for aspirin allergy)
17
Q

inflammation of infection of NASAL MUCOSA and paranasal sinuses lasting <4WKS

A

Acute Rhinosinusitis (maxillary sinus most common)

18
Q

Most acute rhinosinusitis’ are

A

viral (rhinovirus, flu, paraflu)

19
Q

acute rhinosinusitis criteria for urgent referral (bacterial) (3)

A
  1. abnormal vision
  2. altered mentation
  3. periorbital edema
20
Q

acute rhinosinusitis hallmark

A

“double-worsening”

21
Q

acute viral rhinosinusitis =
acute bacterial rhinosinusitis =
real world

A
  • cold

- sinusitis

22
Q

Dx of acute rhinosinusitis (3)

A
  1. cultures not accurate
  2. CT – used to r/o complications
  3. MRI – used to r/o complications
23
Q

Acute rhinosinusitis TX

A

symptomatic OTC – be careful abt overlap

24
Q

An INFLAMMATORY condition involving the nasal mucosa and paranasal sinuses that lasts 12 WEEKS or LONGER

A

Chronic Rhinosinusitis

25
Q

S&S of chronic rhinosinusitis (4)

A
  1. anterior/posterior nasal mucopurulent drainage
  2. congestion/ obstruction
  3. Facial pain/pressure
  4. anosmia
26
Q

CRS subtypes (3) high to low fq

A
  1. CRS w/out nasal polyposis–allergic rhinitis
  2. CRS w/ nasal polyposis– ass w/ AERD, polyps bilat
  3. Allergic fungal rhinosinusitis–allergic mucin
27
Q

AERD

A

aspirin exasperated respiratory disease

28
Q

thick mucus from light tan to brown to dark green, containing degranulated Eos w/ fungal hyphae

A

allergic mucin

29
Q

chronic rhinosinusitis dx

A
  1. subjective–2 or mor lasting >12 wks

2. objective–documentation of inflammation

30
Q
  • Chronic Rhinosinusitis Tx
A
  1. Nasal Saline

2. Intranasal glucocorticoids

31
Q

Anterior ___ Posterior epistaxis

A

>

32
Q

Anterior epistaxis etiology (4)

A
  1. trauma (nose picking)
  2. low moisture
  3. hyperemia
  4. foreign body
33
Q

Posterior epistaxis etiology (5)

A
  1. anticoagulation
  2. HHT
  3. bleeding disorder
  4. aneurysm
  5. neoplasm
34
Q

suspected history w/ epistaxis (3)

A
  1. coagulation disroder or medication
  2. recent trauma
  3. Fq and severity of bleed
35
Q

anterior plexus highly implicated in epistaxis

A

Kiesselbach’s plexus

36
Q

Tx epistaxis (3) in order

A
  1. pressure
  2. cautery
  3. nasal packing (tampon, balloon)
37
Q

1 site for foreign body

A

right nare

38
Q

foul odorous mucopurulent nasal discharge ^ in

A

nasal foreign body