Nose Disease

Question 1

T/F: Rhinitis is always infective.

Answer 1

False (can be autoimmune)

Question 2

What is intermittent allergic rhinitis?

Answer 2

Symptoms <4 days per week OR symptoms <4 weeks duration.

Example: hay fever

Question 3

What is persistent allergic rhinitis?

Answer 3

Symptoms >4 days per week AND symptoms present for >4 weeks

Question 4

How is “mild/moderate” rhinitis delineated?

Answer 4

Moderate impacts sleep and school

Question 5

How is rhinitis treated? (allergic)

Answer 5

1) Allergen avoidance
2) Anti-histamines
3) Topical steroids
4) Combination of 3 and 4

Question 6

Rhinitis can lead to what secondary complication?

Answer 6

Mucosal hypertrophy - can push the orbits apart

Question 7

Nasal polyps are most commonly associated with allergic/ non-allergic asthma?

Answer 7

Non-allergic

Question 8

What is the 1st line treatment in nasal polyps?

Answer 8

Oral steroids
THEN topical steroids.
If not resolving, surgery to remove.

Question 9

Severe nasal polyps can lead to blockage of which sinus

Answer 9

Frontal

Question 10

Most infective rhinitis cases are due to bacteria/virus?

Answer 10

Virus

Question 11

Treatment of infective rhinitis

Answer 11

Analgesia + decongestant

Question 12

T/F: Polyps are a cause of non-allergic rhinitis.

Answer 12

True

Question 13

What’s the first line investigation for allergic rhinitis?

Answer 13

Skin prick testing (NOT patch testing).

Question 14

Should x-rays be given in allergic rhinitis?

Answer 14

No

Question 15

When is rhinitis treated with antibiotics? What is the antibiotic of choice?

Answer 15

Only if symptoms become severe.

Penicillin V PO 500mg QDS for 7 days (doxycycline if allergic)

Question 16

Which tonsils can block the nose if they become enlarged?

Answer 16

Adenoids

Question 17

How is orbital cellulitis treated?

Answer 17

IV Ceftriaxone + IV flucloxacillin + IV metronidazole. Step down to PO co-amoxiclav.

(orbital cellulitis is a complication of acute rhinosinusitis)