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HEENT Clin Med > nose & paranasal sinuses > Flashcards

nose & paranasal sinuses Flashcards

1
Q

How long can viral particles remain viable on skin

A

2 hours

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2
Q

What is the most common cause of URIs

A

Rhinovirus

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3
Q

What is another name for influenza

A

Syncytial virus

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4
Q

How many episodes of the common cold will preschool kids have

A

5-7

2-3 for adults

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5
Q

What is the best way to diagnose URI

A

clinically

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6
Q

What are common findings with URI

A

conjunctival injection
nasal mucosa swelling
pharyngeal erythema
exudates & cobblestoning

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7
Q

how long do URI symptoms typically last

A

5-10 days
*can be up to 14

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8
Q

How long are people infectious with URI

A

as long as symptoms are present

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9
Q

What are the most common forms of rhinitis

A

allergic
vasomotor
rhinos medicamentosa

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10
Q

What is generally the cause of allergic rhinitis

A

Climate changing resulting in an increased amounts of pollen

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11
Q

what type of pollen is present in the spring

A

flowers and trees

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12
Q

What type of pollen is present in summer

A

flowers and grass

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13
Q

What type of pollen is present in fall

A

ragweed and mold

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14
Q

What type of immune response is allergic rhinitis

A

IgE

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15
Q

What are signs and symptoms of allergic rhinitis

A

nasal itching
watery rhinorrhea
sneezing
dry cough
itchy/watery eyes

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16
Q

What is seen on physical exam with allergic rhinitis

A

nasal polyps
allergic salute in kids
pale/boggy/bluish nasal mucosa

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17
Q

What is vasomotor rhinitis

A

increased secretion from nasal mucosa precipitated by temp or humidity, odors, alcohol, neuromuscular imbalance

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18
Q

What is senile rhinitis

A

clear rhinorrhea from increased sensitivity of the vidian nerve

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19
Q

What is rhinitis medicamentosa

A

rebound congestion from overuse of nasal decongestants

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20
Q

What is acute sinusitis / rhino sinusitis (ARS)

A

Inflammation in nasal cavity and para-nasal sinuses

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21
Q

What is the most common etiology of ARS

A

Viral infections

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22
Q

what are the risk factors of ARS

A

Older age
recent URI
chronic rhinitis
cigarette smoking
allergies

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23
Q

What is the main difference between viral and bacterial sinusitis

A

Bacterial will have purulent discharge and duration >10days and worsening

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24
Q

How do you treat bacterial sinusitis

A

amoxicillin- clavulanate (Augmentin) for 10-14 days

*If PCN allergy = doxy or levaquin

25
Q

When do you use abx with bacterial sinusitis

A

when s/sx have lasted >10days or if symptoms are severe / complicated

26
Q

What duration of time does sinusitis have to last to be considered chronic

A

> 12weeks

27
Q

What are symptoms of chronic sinusitis

A

persistent rhinorrhea
productive cough
foul breath
facial/dental pain

28
Q

What are s/sx of complications with bacterial sinusitis

A

indications spread beyond paranasal sinuses to CNS, orbit, or surrounding tissue

*urgen referral to otolaryngologist

high persistent fever >102
vision changes
cranial nerve palsies
AMS

29
Q

What is the imaging of choice when there are complications with acute bacterial sinusitis

A

CT

30
Q

What are common pathogens for chronic sinusitis

A

s. aureus
S. pneumo
Anaerobes
Fungus
*mostly mixed flora

31
Q

What are some nasal mucosal disorders

A

turbinate hypertrophy
rhinosinusitis
rhinitis
nasal polyposis

32
Q

What are some nasal structural disorders

A

turbinal hypertrophy
septal disorders
adenoid hypertrophy
foreign body
tumors

33
Q

What are some inflammatory nasal mucosal obstructions

A

rhinosinusitits
rhinitis
polyps
sarcoidosis
wegeners

34
Q

What are some infectious nasal mucosal obstructions

A

HIV
Syphilis
TB

35
Q

What types of medications can cause mucosal nasal obstruction

A

thyroid meds
BP meds
anti-depressants
NSAIDs
PDE-5 inhibitors
benzodiazepines

36
Q

How do you treat a deviated septum

A

nasal endoscopy
surgery
implants

37
Q

What is the most common cause of nasal obstruction in children

A

adenoid hypertrophy

38
Q

What are symptoms of nasal hypertrophy

A

mouth breathing
mucopurulent discharge
snoring
sleep apnea

39
Q

What can cause adenoid hypertrophy

A

Chronic inflammation
allergies
chronic sinus symptoms

40
Q

What is long term damage that can occur with adenoid hypertrophy

A

adenoid facies

*prolonged mouth breathing due to adenoid hypertrophy affects facial and dental growth/development

41
Q

How do you diagnose adenoid hypertrophy

A

clinical suspicion
endoscopic visualization

42
Q

How do you treat adenoid hypertrophy

A

adenoidectomy

43
Q

What is the most common tumor of the nasal cavity

A

nasal polyp

44
Q

What will be seen on physical exam with nasal polyps

A

nasal obstruction
pale mucosa
fleshy mass with superficial vessels

45
Q

Where are foreign bodies of the nose located

A

floor of nasal passage just under the inferior turbinantes
or
superiorly in nasal cavity just in front of middle turbinate

46
Q

What is the risk with a button battery being up the nose

A

septal perforation within 4 hours

47
Q

How can you remove foreign bodies from the nose

A

Fogarty catheter
Katz extractor
forceps
irrigation

48
Q

what is a Keisselbach plexus

A

most common location for anterior epistaxis

49
Q

Where do most nose bleeds occur

A

anterior

50
Q

What is the source of posterior nose bleeds

A

posterolateral branches of sphenopalantine artery

51
Q

What are the most common causes of nose bleeds

A

nose picking
dryness
allergic / viral rhinitis
foreign body
cocaine
blunt trauma

52
Q

How do you treat anterior nose bleeds

A

clear clots
topical meds
+/- TXA
direct pressure for 15 min
cauterize
nasal packing

53
Q

After cautery of the nose, what are you not allowed to do

A

blow nose or sneeze

54
Q

how do you treat a posterior nose bleeds

A

tamponade the bleed
-Foley catheter
-Brighton
-simpson balloon
-arterial ligation
-embolization

55
Q

What is the most common cause of facial pain

A

trigeminal neuralgia

56
Q

What are some causes of facial pain

A

trigeminal neuralgia
trigeminal neuropathy
cluster-tic syndrome
glossopharyngeal neuralgia

57
Q

What is trigeminal neuralgia

A

Paroxysmal attack of intense, sharp, superficial, stabbing pain in distribution of one or more branches of trigeminal nerve

58
Q

Where is pain the highest with trigeminal neuralgia

A

at or near onset and describes as electric, shock-like, or stabbing

59
Q

What is the treatment of choice for trigeminal neuralgia

A

carbamazepine

HEENT Clin Med (7 decks)

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