Nose-ENT Flashcards

1
Q

differential for nasal obstruction

A
congenital- choanal atresia
anatomical- deviated septum
FB
inflammatory
neoplastic
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2
Q

inflammatory causes for nasal obstruction

A
  • polyp
  • sarcoid
  • wegners
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3
Q

neoplastic cases for nasal obstruction

A
  • papilloma
  • SCC
  • juvenile nasopharyngeal angiofibroma
  • inverted papilloma
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4
Q

empiric tx nasal obstruction

A

STEROIDS- spray
DECONGESTANT- spray or drops
ANTIBIOTICS

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5
Q

dx of nasal obstruction

A

pan-endscopy

fog-up mirror test

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6
Q

red flag symptoms for nasal obstruction

A
UNI-epistaxis
UNI-blockage
UNI-swelling
ear effusion
neck swelling
atypical pain
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7
Q

tx allergic rhinitis

A
  • topical steroid spray
  • nasal douches– neilmed + streimar
  • surgery– diathermy/ turbinate reduction
  • FESS
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8
Q

nasonex

A

mometasone furoate monohydrate + glucocorticoids

>12yo

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9
Q

avamys

A

fluticasone furoate + glucocorticoids

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10
Q

rynacrom

A

sodium cromoglycate

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11
Q

atrovent

A

ipratropium bromide

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12
Q

PC nasal polyps

A

BILATERAL

  • anosmia
  • nasal obstruction
  • sneezing
  • rhinorrhea
  • pale
  • boggy edematous mucosa
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13
Q

tx nasal polyps

A

steroids

surgery– FESS, polypectomy

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14
Q

steroids for nasal polyps

A

spray– 6 months
drops– 2-3weeks
oral– 10 days

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15
Q

MCC unilateral polyp

A

inverted papilloma

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16
Q

Dx- inverted papilloma

A

MUST BIOPSY– since can go on to SCC

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17
Q

inverted papilloma associated with

A

MENINGOCELE

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18
Q

dx nasal polyps

A

endoscopy–pale and grey polypoid mass

- bogy and oedematous mucosa

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19
Q

dx nasal polyps imaging:

A

CT paransal sinuses= radio-opaque

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20
Q

dx of nasal FB

A
  • lateral nasal XR

- CXR: inspiratory and expiratory

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21
Q

tx of nasal FB

A

GA–removal

bronchoscopy if aspirate

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22
Q

dx of choanal atresia

A
  • fogging metal spatula
  • NGT/catheter
  • fibreoptic scope
  • CT: bony or membranous mixed
23
Q

vaso-motor rhinitis=

A

NON-allergic rhinitis

24
Q

risk factors for non-allergic rhinitis

A

fumes/ pregnancy/ drugs

DIAGNOSIS OF EXCLUSION

25
Q

MAJOR symptoms for rhinosinusitis

A
  • nasal obstruction
  • rhinorrhea
  • facial pressure
  • fever
  • olfactory changes
26
Q

minor symptoms for rhinosinusitis

A
  • headache
  • fatigue
  • cough
  • hallitosis
  • dental pain
  • ear pain
27
Q

endoscopy findings rhinosinusitis

A

MOON
Mucopurulent discharge in middle meatus
Oedema / Obstruction in middle meatus
Nasal polyps

28
Q

CT findings rhinosinusitis

A

mucosal changes–> osteomeatal complex and/or sinuses

29
Q

duration of acute rhinosinusitis

A
30
Q

duration of chronic rhinosinusitis

A

> 12 weeks– incomplete resolution

31
Q

patient causes of rhinosinusitis

A
STRUCTURAL
- nasal tumor
- septal deviation
- nasal polyp
MUCOCILIARY CLEARANCE
- CF
- immotile cilia
IMMUNODEF
- HIV
32
Q

environmental causes of rhinosinusitis

A
SOC-FAM
smoke
occupational
chemicals
fungi
allergens
medications
33
Q

dx of acute sinusitis

A

endoscopy/rhinoscopy

= PUS IN MIDDLE MEATUS

34
Q

tx of acute sinusitis

A
  • Abx: co-amox or vibramycin
  • decongest: ephedrine or otrovine
  • steroids
  • bed rest/ analgesia
35
Q

causes of chronic sinusitis

A

ANAEROBES

S.AUREUS

36
Q

dx of chronic sinusitis

A

allergy test;

exclude: polyp/ tumor/ septal deviation

37
Q

tx of chronic sinusitis

A
  1. abx
  2. cause
  3. steroids– topical/oral (decreases inflammation, increases drainage)
38
Q

infective viral causes of chronic sinusitis

A

rhinovirus
adenovirus
RSV
parainfluenza

39
Q

infective bacterial causes of chronic sinusitis

A

simple
syphilis
TB

40
Q

non-allergic rhinitis= non-infective rhinitis=

A

non-allergic eosinophilic rhinitis

  • occupational
  • hormonal
  • drug induced
  • gustatory
  • vasomotor
41
Q

ARIA

A

allergic
rhinitis and its
impact on
asthma

42
Q

seasonal causes of allergic rhinitis

A

POLLENS

43
Q

perennial causes of allergic rhinitis

A
  • house dust mite
  • animal dander
  • chemicals
  • food
  • fungospores
44
Q

tx allergic rhinitis

A
  1. avoid allergen
  2. saline douching
  3. anti-histamine
  4. surgery– obstruction only: septoplasty or turbinate reduction
  5. immunotx– desens–> sc, sublingual
45
Q

3 big indications for rhinitis surgery

A
  1. COMPLICATIONS
  2. FUNGAL
  3. NEOPLASM suspected
46
Q

3 complications indicating need for rhinitis surgery

the intra-cranial complications

A
  1. meningitis
  2. abscess
    - brain
    - subperiosteal orbital
  3. cavernous sinus thrombosis
47
Q

3 surgical options for rhinitis

A
  • septal surgery
  • polypectomy
  • FESS
48
Q

basis behind FESS

A

unblocks osteometal complex–> aeration and drainage of sinuses;
performed under image guidance

49
Q

FESS nasal complications

A
  • epistaxis
  • infection
  • adhesions
  • anosmia/hyposmia
50
Q

FESS orbital complications

A
  • haematoma

- optic nerve trauma

51
Q

FESS intra-cranial complications

A
  • CSF leak

- meningitis

52
Q

rhinitis miscellaneous complications

A
  • LRTI
  • AOM
  • osteomyelitis= POTTS PUFF TUMOR
53
Q

orbital complications of rhinitis

A
  • abscess

- periorbital cellulitis (mc in kids, with URTI before)