Nose problems

Question 1

Allergic Rhinitis s/t/PE

Answer 1

daily or seasonal symptoms of clear mucus, itchy nose, nasal/facial congestion

PE: nasals turbinates will be pale, bluish, and swollen with mucus drainage. Pharynx coated with mucoid discharge

TX: 1. intranasal steroids ( flonase, Rhinocort)

   2. oral antihistamines ( zyrtec, allergy, clarity (weak))
   2. Deocongestant for short term

Question 2

What is the most common type of epistaxis ? What is the tx?

Answer 2

Anterior nosebleeds which are caused by bleeding at the kiesselbachs plexus

tx: Sit and lean forward and pinch lower half of nose x 15 -20 min can use an topical nasal decongestant (Afrin)

Question 3

what is the most common cause of nasal septum perforation?

Answer 3

cocaine use (vacocontriction)

Question 4

what is vertigo? signs PE

Answer 4

sensation of unsteadiness feeling like the room is spinning around you

PE: unstable gait, nystagmus present

Question 5

Meniere’s Disease

Answer 5

sensorineural hearing loss
recurrent attacks of vertigo with n/v
may last several hours

TRIAD:
tinnitus, hearing loss, vertigo

TX: self limiting, tx acute attacks w/ low salt diet, no alcohol, avoid caffeine, meclinzine, antihistamine, diuretic, oral corticosteroids

Question 6

Results of Weber and Rinne test for sensorineural hearing loss

Answer 6

W: lateralization to good ear

R : AC > BC

Question 7

Results of Weber and Rinne test for conductive hearing loss

Answer 7

W: laterization to the bad ear
R: BC > AC

Question 8

Normal Weber Rinne results

Answer 8

W: No lateralization
R: AC>BC

Question 9

Types of sensorineural hearing loss ?

Answer 9

blocking of the inner ear

Presbycusis or Menieres disease

Question 10

Types of Conductive hearing loss?

Answer 10

blocking of the outer and middle ear

Otitis media, serous otitis media, ceruminosis, perforation of tympanic membrane

Question 11

Acoustic Neuroma

Answer 11

Ages: 30-60
Gradual onset, one sided, hearing loss and tinnitus that is insidious
facial numbness indicated ( compression of CN5)

caused by benign tumor of CN 8
order an MRI

Question 12

BPPV

Answer 12

recurrent vertigo lasting under one minute caused by sudden changes head position

may be canalith (calcium crystals) in the vestibular system of the ear

TX: epley maneuver to reposition the crystals

Question 13

Vestibular Neuritis and Labyrinthitis

Answer 13

sudden/rapid onset of severe, vertigo with n/v for 1-2 days, gradual lessening,

problems walking and balancing

casued by viral infections

tx: steroids, antiemetics,