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nose/sinus > nose/sinus > Flashcards

nose/sinus Flashcards

1
Q

inflam of nasal cavity and paranasal sinuses causing nasal congestion, purulent drainage, and facial pain

A

rhinosinusitis

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2
Q

rhinosinusitis resolves in

A

acute

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3
Q

rhinosinusitis resolves 30-90d

A

subacute

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4
Q

rhinosinusitits w 3 episodes

A

recurrent acute

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5
Q

rhinosinusitis >90d w persistent symp

A

chronic sinusitis

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6
Q

path of viral rhinosinusitis

A
  • direct inoculation via direct contact

- virus spreads paranasal sinuses by blowing nose and inc intranasal pressure that can impair nasal cilia

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7
Q

pt presents w mucosal edema, copious thickened secretions, and ciliary dyskinesia

A

viral rhinosinusitis

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8
Q

path of bacterial rhinosinusitis

A

complication viral sinusitis which bacteria take advantage of compromised cavities

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9
Q

risk factors of bacterial rhinosinusitis

A

allergic rhinitis, cocaine use, mechanical obstruction, swimming, dental infx, cystic fibrosis, immunocomp

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10
Q

organisms that can cause bacterial rhinosinusitis

A

strep pneumo
h infl
m cat

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11
Q

risk factors of rhinosinusitis

A

URI, allergic rhinitis, anatomical obstruction, mucosal irritants, sudden change atmospheric pressure

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12
Q

pt presents with nasal congestion, purulent drainage made worse when bends over

A

rhinosinusitis

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13
Q

pt presents nasal congestion, maxillary tooth pain, cough, ear pressure

A

rhinosinusits

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14
Q

guidelines for bacterial rhinosinusitis

A

persistent symp 10d w no improvement
severe symp or fever 102 w purulent discharge/facial pain for at least 3/4 consecutive days beginning
worsening symp following typical viral URI that lasted 5/6day and were initially improving

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15
Q

when should get ct with sinusitis

A 
diminished visual acuity
diplopia
periorbital edema
severe HA
altered mental status
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16
Q

supportive tx viral rhinosinusitis

A
  • nasal irrigation
  • analgesics: tylenol/motrin
  • top ster: flonase (fluticasone), nasacort (triamcinolone)
  • top dec: afrin (oxymetazoline)
  • oral dec: sudafed (pseudoephedrine), phenylephrine
  • mucolytics: mucinex (guiafenesin)
17
Q

tx for bacterial rhino sinusitis if >7d

A

amoxicillin-clavulanate (augmentin)
500 TID 875 BID 5-7d
peds- 90/kg 10-14 d

18
Q

what should give person who is allergic to augmentin when tx bacterial rhinosinusitis

A

doxy or levofloxacin

19
Q

what tx do you want to avoid for bacterial sinusitis

A

macrolides, bactrim, 2/3 gen cef due to inc resistance s pneumo

20
Q

what should give kid with allergy to augmentin in tx bacterial sinusitis

A

anaphy- levofloxacin

mild- cefdodoxime, cefdinir, levofloxacin

21
Q

3 types of chronic sinusitis

A

chronic w polyps
without polyps
allergic fungal

22
Q

translucent, yellowish grey glistening masses filled w inflammatory material

A

nasal polyps

23
Q

what will be shown on ct of chronic sinusitis

A

muscosal thickening, obstruction, sinus opacification, mucus retention cysts, nasal polyps

24
Q

tx chronic sinusitis by ent

A

abx w oral steroids for several weeks, long term macrolide therapy, surgical debridement, antileukotrienes, antihistamines

25
Q

pt presents with sneezing, itchy/watery eyes, and cough

A

allergic rhinitis

26
Q

pt presents w sneezing, itchy palate, post nasal drip and fatigue

A

allergic rhinitis

27
Q

path of allergic rhinitis

A

produce allergen specified IgE that binds to rec on mast cells/basophils when exposed again release histamine, prostaglandins, leukotrienes

28
Q

allergic shiners

A

seen with allergic rhinitis

infraorbital edema and darkening

29
Q

allergic salute

A

allergic rhinitis

transverse nasal crease from rubbing

30
Q

pt presents with sneezing, nasal itching, pale bluish nasal mucosa, and cobblestoning

A

allergic rhinitis

31
Q

tx allergic rhinitis

A
  1. intranasal steroids- flonase (fluticasone), nasacort (triamcinolone), nasonex (mometasone) *nosebleeds
  2. oral antihist- 1st gen: diphenhydramine (benadryl), hydroxyzine (atarax) *sedation/dec driving
    - 2nd gen: ioratadine (claritin), cetirizine (zyrtec), fexofenadine (allegra)
  3. montelukast (singulair)
32
Q

tx kids

A

cromolyn nasal spray

2nd gen antirust after 6m

33
Q

tx kids >2

A

nasal steroids
cromolyn
2nd gen antihist

nose/sinus (1 decks)

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