Nose conditions

Question 1

likely cause of unilateral runny nose in kids

treatment

Answer 1

foreign body

urgent referral for removal

Question 2

likely cause of unilateral runny nose in adults

treatment

Answer 2

nasal/paranasal tumour

urgent referral for removal

Question 3

most common cause of acute sinusitis

Answer 3

viral infection (bacterial rare) after URTI

Question 4

cause of sinusitis in eczema patient

Answer 4

hayfever

Question 5

why do the paranasal sinuses get blocked (then filled up) when the mucosa is inflamed

Answer 5

ostia (drainage hole) is blocked

Question 6

tooth extraction is a risk factor for what type of sinusitis (area)

Answer 6

maxillary sinusitis

Question 7

treatment of acute sinusitis (2)

Answer 7

self limiting <2 and a half - bc most are viral

antibiotics (penicillin V 500mg QDS for 5 days) if >2 and a half weeks

Question 8

aetiology of rhinitis (4)

Answer 8

allergic
polyps
viral URTI (rhinosinusitis)
drugs

Question 9

presentation of rhinitis (4)

Answer 9

runny nose
sneezing
itching
allergic crease (from rubbing nose)

Question 10

investigations for rhinitis (2)

Answer 10

skin prick

IgE levels

Question 11

treatment for allergic rhinitis (3)

Answer 11

allergen avoidance
antihistamines
topical steroids

Question 12

treatment for infective rhinitis (3)

Answer 12

analgesia
nasal decongestants
antibiotics (rarely)

Question 13

what should you suspect in a kid with nasal polyps

Answer 13

CF

Question 14

what are nasal polyps made from

Answer 14

fluid (oedema)

Question 15

what is the cause of a nasal polyp with eosinophils on histology

Answer 15

allergy

Question 16

aetiology of nasal polyp (3)

Answer 16

asthma (non allergic)
allergy
infection

Question 17

chronic blocked nose
sinusitis
reduced sense of smell
painless

Answer 17

nasal polyp

Question 18

what does a nasal polyp look like on otoscopy

Answer 18

odematous lump up nose

Question 19

rare complication of rhinitis

Answer 19

orbital cellulitis

Question 20

treatment of nasal polyps (2)

Answer 20

steroids (PO or topical)

surgery

Question 21

saddle nose
oral ulcers
nose bleeds
sinusitis

Answer 21

GPA vasculitis (wegeners)

Question 22

are tumours in the nose common

Answer 22

no, v rare (probs just a polyp)

Question 23

most common tumour in the nose

Answer 23

nasopharyngeal carcinoma

Question 24

what other ENT condition is nasopharyngeal carcinoma associated with

Answer 24

infectious mononucleosis (glandular fever, EBV virus)

Question 25

where do anterior nosebleeds (epistaxis) come from

Answer 25

kiesselbachs/littles area

Question 26

% of population with nosebleeds (epistaxis)

% life threatening

Answer 26

5-10%

1%

Question 27

home treatment of nosebleeds (epistaxis) (3)

Answer 27

pinch front of nose for 20 mins sitting forwards
ice pack to slow flow of blood
blow out clots

Question 28

hospital treatment of severe nosebleeds (epistaxis) if >20 mins (3)

Answer 28

topical vasoconstrictor eg adrenaline in cotton wool (slow blood flow) 
cauterise vessels (silver nitrate) 
anterior rhinoscopy (looks like a tampon)

Question 29

NOSE TRAUMA

what is a septal haematoma

Answer 29

collection of blood between perichondrium and nasal septal cartilage

Question 30

treatment of septal haematoma

Answer 30

surgery to reattach perichondrium

Question 31

recent nose trauma
asymmetrical septum
red bulge on one side when you look up nose

Answer 31

septal haematoma

Question 32

treatment of nasal fracture

Answer 32

nothing
ice and pain medication

surgery - only for cosmesis if v bad

Question 33

investigation of ?nasal fracture

Answer 33

nothing (nope not even an xray)

Question 34

complication of cribiform plate fracture

Answer 34

anosmia (loss of sense of smell)