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HEENT > Nose MDT > Flashcards

Nose MDT Flashcards

1
Q

What is epistaxis?

A

Bleeding from nasal cavity

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2
Q

What is the most common form of epistaxis?

A

Unilateral, anterior nasal cavity

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3
Q

What is a rare finding that may cause epistaxis?

A

HTN

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4
Q

What labs should be done for epistaxis?

A

Coagulation tests
- Prothrombin time (PT)
- Activated partial thromboplastin time
(aPTT)
- Thrombin Time (TT)

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5
Q

Conservative treatment of epistaxis?

A

Direct pressure by compression of nares continuously for 15 minutes

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6
Q

What medications could you give for epistaxis?

A

Topical Nasal Decongestants
- Phenylephrine
- Afrin
Topical Anesthetic
- Lidocaine

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7
Q

What procedure can you perform for epistaxis?

A

Cautery with silver nitrate

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8
Q

How would you insert nasal packing for anterior epistaxis?

A
  • Accordion like
  • Placed in floor of nose
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9
Q

What medication should be given to prevent toxic shock syndrome from packing?

A

Cephalexin or Clindamycin

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10
Q

How long can packing stay before needing to give antibiotics?

A

5 days

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11
Q

What should be applied frequently to nasal packing?

A

NS to keep it moist

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12
Q

What are nasal polyps?

A

Benign nasal tumors arising from nasal mucosa

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13
Q

What is strongly associated with nasal polyps?

A
  • Allergic rhinitis and food allergies
  • asthma 20-50%
  • ASA intolerance 8-26%
  • Alcohol intolerance 50%
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14
Q

What radiological study should be done for nasal polyps?

A

CT of nose and paranasal sinuses

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15
Q

What medications can be given to patients with nasal polyps?

A

Topical Intranasal corticosteroids
- Flonase
- Nasonex
Short course oral corticosteroids
- Prednisone

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16
Q

How should massive nasal polyps be treated?

A

Surgically

17
Q

What is the most frequently fractured bone in the body?

A

Nasal pyramid

18
Q

Signs and sx of nasal trauma?

A
  • Crepitus
  • palpable step off of infraorbital rim
19
Q

When would radiologic tests not be indicated for nasal trauma?

A

Uncomplicated nasal fractures

20
Q

If you did a radiologic test for nasal trauma, what would it be?

A

CT

21
Q

Treatment of simple nasal trauma?

A

Non specific
Acetaminophen
Nasal packing (usually unnecessary)

22
Q

For extreme nasal trauma, what treatments should be done?

A
  • Refer to emergency ENT (realignment, closed reduction)
  • Surgery (septoplasty or rhinoplasty)
23
Q

What causes seasonal allergic rhinitis?

A

Airborne allergens such as pollen

24
Q

What causes perennial allergic rhinitis?

A

Dust mites, animal dander and mold

25
Q

What is allergic rhinitis?

A

Inflammatory response in the nasal mucosa in response to specific allergen

26
Q

Sx of rhinitis

A
  • Clear rhinorrhea
  • Turbinates pale or violaceous (venous engorgement
27
Q

Intranasal corticosteroid medications for rhinitis?

A

Flonase or nasonex for 1-3months

28
Q

How does the patient administer intranasal corticosteroid medications?

A

Hold bottle upwards, straight up with head tilted forward and bottle pointing towards ipsilateral ear when spraying

29
Q

Antihistamine treatment of rhinitis?

A
  • Loratadine (Claritin) 10mg PO daily
  • Fexofenadine (Allegra) 60mg po BID or 120mg daily
30
Q

What is sinusitis?

A

Inflammation of mucous membrane of one or more paranasal sinuses

31
Q

Sx of sinusitis?

A
  • Purulent yellow-green nasal discharge
  • facial pain or pressure over sinuses
  • Acute onset
32
Q

How should you treat pain with sinusitis?

A

NSAIDS

33
Q

What decongestants should be used with patients with sinusitis?

A

Pseudophedrine 30-60mg q 4hrs, max 240mg/day
Nasal Oxymetazoline (afrin) 1 or 2 sprays in each nostril q6-8hrs for up to 3 days

34
Q

What antibiotics should be given for patients with bacterial sinusitis?

A
  • Empiric
    -Amoxicillin-Clavulanate 500mg/125mg PO TID or 875/125mg PO BID for 5-7days
  • Severe
    • Amoxicillin-Clavulanate 2000mg/125 XR PO BID for 7-10 days
  • PCN Allergy or hepatic impairment
    • Doxycycline 100mg PO BID or 200mg PO daily for 5-7days

HEENT (9 decks)

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