Nose and Sinus Flashcards
Most common virus for URI?
Rhinovirus
What are the amount of days for incubation of a URI
How long is the duration?
2-3 days
3-10 days
Treatment options for Common colds
- Supportive Care (rest, hydrate)
2. Patient education (expected duration and discuss antibiotics)
Medications for Common Colds
-Zinc,
-Nasal saline irrigation
-Decongestants: pseudoephedrine, phenylephrine
-NSAIDS, Acetaminophen
Slide 13
Etiology behind Acute Rhinosinusitis
Viral: Rhinovirus, influenza,
Bacterial: Stept Pneumo (most common), H. Influenza, Moroxcilla 0.5-2%d
Symptoms of Acute Rhinosinusitis
- Nasal congestion
- Purulent nasal dishcharge
- Facial pain or pressure
- Maxillary tooth discomfort
Warnings signs of complications with Acute Rhinosinusitis
- Fever w/ headache
- Abnormal vision (EOM’s, diplopia, blindness )
- Change in mental status
- Periorbital edema/cellulitis
- Cranial nerve palsies
Clues that indicate a bacterial cause of Acute Rhinosinusitis?
- Symptoms lasting longer than 10 days with no improvement
- Sever systems lasting at least 3 days since onset (fever, purulent discharge, facial pain)
- Onset with worsening symptoms after a viral URI that last 5-6 days and was initially improving
What are indications for referral for urgent endoscopy or surgery in Acute Rhinosinusitis?
- Failure to respond to 1st and 2nd line treatments
Complications of Acute Rhinosinusitis
- Periorbital or orbital cellulitis
- Meningitis
- Osteomyelitis of sinus bones
- Intracranial abscess
Management for Chronic Rhinosinusitis
slide 33
Risk factors for Allergies
- Family history
- Males
- Birth during pollen season
- First borns
Etiology behind Allergic rhinitis
slide 36
Intermitten Allergies
Less then 4 days/week for less than 4 weeks
Persisten Allergies
More than 4 days/week for more than 4 weeks
Mild Allergies
Does not meet any crit
Moderate-Severe
1 or more of the following criteria:
- Trouble sleeping
- Impaired school/work
- Impaired daily activities
- Troublesome symptoms
Clinical/Physical signs of Allergies
- Infraorbital edema/darkening “allergic shiners”
- Allergic salute
- Nasal mucosa is pale-bluish color
- Clear rhinorrhea
- Hyperplastic lymphoid tissue in posterior pharynx
- TM retraction or serous fluid behind TM
What are the Allergic skin tests used to diagnose? What can interfere with testing
- Prick skin test- most commonly used
- Intradermal skin test
- Serum IgE
* Need to discontinue medications
Non-allergic rhinitis triggers?
- Temperature changes
- Eating (spicy foods)
- Exposure to odors/chemicals
Clinical presentation of Nonallergic rhinitis
- nasal congestion
2. Postnasal drainage
Treatments for nonallergic rhinitis
- Topical intranasal glucocorticoids
2. Topical antihistamines (azelastine)
Most common Epistaxis (Nose bleeds)
What are the branches involved
Anterior bleeds
Most common cause of Epistaxis?
Nasal trauma
Treatment for Epistaxis
- Occlusion/pressure continuously for 10-15 min, lean forward, cold compress
- Cautery- silver nitrate or electrical
- Nasal Packing - Nasal tampon, Gauze packing, Nasal balloon catheter
What do you do is have persistent nose bleeding?
- Pack contralateral side
- ENT consult
- If its a posterior bleed = emergency
Samster Triad?
Nasal polyps + asthma = avoid aspirin
Can cause Bronchospasms
Treatment for Nasal Polyps?
- Intranasal corticosteroids
2. Surgical removal
Most common development of Acute Sinusitis?
URI
