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Foundations of Clinical Practice II > Nose and Sinus > Flashcards

Nose and Sinus Flashcards

1
Q

Most common virus for URI?

A

Rhinovirus

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2
Q

What are the amount of days for incubation of a URI

How long is the duration?

A

2-3 days

3-10 days

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3
Q

Treatment options for Common colds

A
  1. Supportive Care (rest, hydrate)

2. Patient education (expected duration and discuss antibiotics)

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4
Q

Medications for Common Colds

A

-Zinc,
-Nasal saline irrigation
-Decongestants: pseudoephedrine, phenylephrine
-NSAIDS, Acetaminophen
Slide 13

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5
Q

Etiology behind Acute Rhinosinusitis

A

Viral: Rhinovirus, influenza,

Bacterial: Stept Pneumo (most common), H. Influenza, Moroxcilla 0.5-2%d

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6
Q

Symptoms of Acute Rhinosinusitis

A
  1. Nasal congestion
  2. Purulent nasal dishcharge
  3. Facial pain or pressure
  4. Maxillary tooth discomfort
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7
Q

Warnings signs of complications with Acute Rhinosinusitis

A
  1. Fever w/ headache
  2. Abnormal vision (EOM’s, diplopia, blindness )
  3. Change in mental status
  4. Periorbital edema/cellulitis
  5. Cranial nerve palsies
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8
Q

Clues that indicate a bacterial cause of Acute Rhinosinusitis?

A
  1. Symptoms lasting longer than 10 days with no improvement
  2. Sever systems lasting at least 3 days since onset (fever, purulent discharge, facial pain)
  3. Onset with worsening symptoms after a viral URI that last 5-6 days and was initially improving
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9
Q

What are indications for referral for urgent endoscopy or surgery in Acute Rhinosinusitis?

A
  • Failure to respond to 1st and 2nd line treatments
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10
Q

Complications of Acute Rhinosinusitis

A
  1. Periorbital or orbital cellulitis
  2. Meningitis
  3. Osteomyelitis of sinus bones
  4. Intracranial abscess
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11
Q

Management for Chronic Rhinosinusitis

A

slide 33

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12
Q

Risk factors for Allergies

A
  1. Family history
  2. Males
  3. Birth during pollen season
  4. First borns
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13
Q

Etiology behind Allergic rhinitis

A

slide 36

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14
Q

Intermitten Allergies

A

Less then 4 days/week for less than 4 weeks

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15
Q

Persisten Allergies

A

More than 4 days/week for more than 4 weeks

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16
Q

Mild Allergies

A

Does not meet any crit

17
Q

Moderate-Severe

A

1 or more of the following criteria:

  • Trouble sleeping
  • Impaired school/work
  • Impaired daily activities
  • Troublesome symptoms
18
Q

Clinical/Physical signs of Allergies

A
  1. Infraorbital edema/darkening “allergic shiners”
  2. Allergic salute
  3. Nasal mucosa is pale-bluish color
  4. Clear rhinorrhea
  5. Hyperplastic lymphoid tissue in posterior pharynx
  6. TM retraction or serous fluid behind TM
19
Q

What are the Allergic skin tests used to diagnose? What can interfere with testing

A
  1. Prick skin test- most commonly used
  2. Intradermal skin test
  3. Serum IgE
    * Need to discontinue medications
20
Q

Non-allergic rhinitis triggers?

A
  1. Temperature changes
  2. Eating (spicy foods)
  3. Exposure to odors/chemicals
21
Q

Clinical presentation of Nonallergic rhinitis

A
  1. nasal congestion

2. Postnasal drainage

22
Q

Treatments for nonallergic rhinitis

A
  1. Topical intranasal glucocorticoids

2. Topical antihistamines (azelastine)

23
Q

Most common Epistaxis (Nose bleeds)

What are the branches involved

A

Anterior bleeds

24
Q

Most common cause of Epistaxis?

A

Nasal trauma

25
Q

Treatment for Epistaxis

A
  1. Occlusion/pressure continuously for 10-15 min, lean forward, cold compress
  2. Cautery- silver nitrate or electrical
  3. Nasal Packing - Nasal tampon, Gauze packing, Nasal balloon catheter
26
Q

What do you do is have persistent nose bleeding?

A
  1. Pack contralateral side
  2. ENT consult
  3. If its a posterior bleed = emergency
27
Q

Samster Triad?

A

Nasal polyps + asthma = avoid aspirin

Can cause Bronchospasms

28
Q

Treatment for Nasal Polyps?

A
  1. Intranasal corticosteroids

2. Surgical removal

29
Q

Most common development of Acute Sinusitis?

A

URI

Foundations of Clinical Practice II (23 decks)

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