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ENT > Nose & Sinus Disorders > Flashcards

Nose & Sinus Disorders Flashcards

1
Q

Functions of the Nose

A

Olfaction
Air filtration & warming
Something to hold up your glasses

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2
Q

Consequences of deficiency in ability to perceive smell

A 
Impairs sense of taste
Lead to nutritional deficiencies
Impairs social interactions
Depression
May be dangerous (fires)
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3
Q

Define Anosmia

A

Inability to detect orders

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4
Q

Define Hyposmia

A

Decreased ability to detect odors

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5
Q

Define Dysosmia

A

Distorted identification of smell

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6
Q

3 Types of Dysosmia

A

Parosmia
Phantosmia
Agnosia

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7
Q

Define Parosmia

A

Altered perceptions of smell in the presence of an odor, usually unpleasant

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8
Q

Define Phantosmia

A

Perception of smell without an odor present

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9
Q

Define Agnosia

A

Inability to classify or contrast odors, although able to detect odors

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10
Q

Conductive Olfaction Defects Affects:

A

Transmission of an odorant stimulus to the olfactory neuroepithelium is disrupted

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11
Q

Sensorineural Olfaction Defects Involves:

A

The more central neural structures

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12
Q

The most common causes of olfactory deficits

A

Viral URI

Head trauma

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13
Q

Causes of Anosmia

A

Midline facial abnormalities

Neurosensory hearing loss

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14
Q

Causes of Dysosmia

A 
Nasal & paranasal sinus disease
Head trauma
URI
Medications
Exposure to toxins
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15
Q

Causes of Parosmia & Hyposmia

A 
Aging & neurodegenerative processes
Nasal obstruction
URI
Head trauma
Facial trauma
Central olfactory damage
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16
Q

Main function of the mucociliary movement

A

Prevent infection & Subsequent problems

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17
Q

Chronic Nasal Congestion Affected by:

A

Allergic rhinitis
Vasomotor rhinitis
Mechanical obstruction
SE of certain drugs/meds

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18
Q

Define Rhinitis

A

Inflammation of the nasal mucosa which can be caused by infection, allergy, or environmental irritants

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19
Q

Types of Infection in Rhinitis

A

Viral
Bacteria
Fungal (rare)

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20
Q

Main type of drug/medication that causes rhinitis

A

Afrin addiction

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21
Q

Hormonal changes that causes rhinitis

A

Hypothyroidism

Pregnancy

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22
Q

Types of chronic inflammatory disease

A

Granulomatosis

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23
Q

Presentation of Rhinitis

A

Nasal congestion
Rhinorrhea/discharge
Epistaxis
Pain (nasal, sinus, pharyngeal, dental)

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24
Q

Define Infectious Rhinitis

A

Inflammation of the nasal passages commonly due to any number of respiratory viruses

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25
Q

Tissues Inflamed in a URI

A

Nasal & nasopharyngeal tissues
Oropharyngeal, laryngeal tissues
Bronchial mucosa

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26
Q

Incidence of the common cold in children

A

6-10 colds/year

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27
Q

Incidence of the common cold in kindergarteners

A

12/year

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28
Q

Incidence of the common cold in school aged children

A

7/year

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29
Q

Incidence of the common cold in adolescents/adults

A

2-4/year

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30
Q

Clinical Presentation of Infectious Rhinitis (cold)

A 
Pharyngitis
Nasal congestion
Rhinorrhea
Obstruction
Sneezing
Facial/ear pressure
Loss of smell/taste
Productive cough
Hoarseness
Headache
Malaise
Fever >100
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31
Q

Causes of the Common Cold

A 
Weather
Exercise & diet
Englarrged tonsils/adenoids
Psychological stressors
Allergic disorders
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32
Q

Main types of Viral Rhinitis

A 
Rhinoviruses
Coronaviruses
Adenoviruses
Orthomyxoviruses
Paramyxoviruses
Echoviruses
RSV
Enteroviruses
Coxsackieviruses
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33
Q

How to Transmit the Cold

A

Touching your skin or environmental surfaces

Inhaling drops of aerosolized mucous material

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34
Q

Differential Diagnosis of the Common Cold

A 
Seasonal allergic rhinitis
Sinusitis: bacterial
Pharyngitis: Group A Strep
CMV
EBV
Mumps
Rubeola
Influenza
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35
Q

Systemic Symptoms of Influenza

A 
Fever >101
Myalgias
Malaise
Severe headache
Lower respiratory tract congestion/cough
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36
Q

Treatment of the Common Cold

A 
Rest
Plenty of fluids
Gargle with warm salt water
Throat sprays, lozenges
Petroleum jelly
Aspirin, Ibuprofen, or acetaminophen
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37
Q

Why can you not use aspirin the children?

A

Reye’s Syndrome

38
Q

What does aspirin promote in children?

A

N/V
Liver inflammation
Progressive mental changes

39
Q

Management of Rhinitis

A 
Antihistamines
NSAIDs
Decongestants
Topical Decongestants
Oral Decongestants
40
Q

What are the best antihistamines for the common cold?

A

Chlorpheniramine (Chlor-Trimeton)
Diphenhydramine (Benadryl)
Brompheniramine (Dimetapp)

41
Q

What NSAIDs are most frequently use for the common cold?

A

Ibuprofen

Naproxen

42
Q

What do decongestants decrease and how?

A

Nasal congestion by causing vasoconstriction

43
Q

Types of Decongestants for the Common Cold

A

Pseudoephedrine (Sudafed)
Phenylephrine
Oxymetazoline

44
Q

What are some unwanted side effects of decongestants?

A

Narrow-angle glaucoma
Poorly controlled HTN
CAD

45
Q

Types of Topical Decongestants for the Common Cold

A

Phenylephrine

Oxymetazoline

46
Q

Types of Oral Decongestants for the Common Cold

A

Pseudophedrine

Phenylephrine

47
Q

Symptoms from unintentional overdose in cough and cold medicines

A

Hives
Drowsiness
Unsteady walking

48
Q

Patient Education for the Common Cold

A

Reassurance
Rest
Increase fluids
Discontinuation of tobacco & alcohol

49
Q

Complications of the Common Cold

A 
Lower respiratory infections
Bronchial hyperreactivity
Exacerbation of chronic lung diseases
OM
Acute sinusitis
Rhinitis medicamentosa
50
Q

Define Sinusitis

A

Inflammatory or infectious process in the paranasal sinuses caused by bacteria, viruses, fungi, allergies

51
Q

Define Acute Rhinosinusitis

A

Symptoms that last less than 4 weeks

52
Q

Define Subacute Rhinosinusitis

A

Symptoms for 4-12 weeks

53
Q

Define Chronic Rhinosinusitis

A

Persists greater than 12 weeks

54
Q

Define Recurrent Acute Rhinosinusitis

A

4+ episodes per year with interim symptoms resolution

55
Q

Pathophysiology of Rhinosinusitis

A

Osteomeatal complex consisting of the outflow tracts of all of the sinuses into the nose

56
Q

What conditions must be present for normal physiologic functioning of the sinuses?

A

Potency of the osteomeatal unit
Normal mucociliary transport
Normal quality/quantity of secretions

57
Q

Factors which predispose one to recurrent sinus infections

A 
Anatomical irregularities
Infections
Allergies
Polyps
Hormones
Environment
Foreign bodies
Cystic fibrosis
58
Q

Common Bugs in Bacterial Sinusitis

A

Strep Pneumo
H. Flu
M. cat

59
Q

Common Bugs for Chronic Sinusitis

A

Staph aureus

Anaerobes

60
Q

Symptoms of Sinusitis

A 
Facial pain or tenderness
Nasal congestion
Purulent nasal & postnasal discharge
Headache
Maxillary tooth pain
Malodorous breath
Fever
Eye swelling
Pain/pressure in cheecks
61
Q

What is the time frame for viral URI’s?

A
62
Q

How long do symptoms need to last in order to be bacterial sinusitis?

A

Greater than 7 days

63
Q

Touchdown or slam dunk symptoms for sinusitis

A

Headache
Facial pain
Fever

64
Q

In order to diagnose sinusitis you need 2+ of the following symptoms

A 
Colored nasal drainage
Poor response to decongestant
Facial pain/Sinus pain
Headache
Biphasic illness which cold symptoms
65
Q

Distinguishing Symptoms for Frontal Sinusitis

A

Pain when forehead over frontal sinuses is touched

Pain exacerbated by leaning forward

66
Q

Distinguishing Symptoms of Ethmoid Sinusitis

A

Pain behind eyes, between eyes

67
Q

Distinguishing Symptoms of Sphenoid Sinusitis

A

Pain behind the eyes

68
Q

Distinguishing Symptoms of Maxillary Sinusitis

A 
Upper jaw & teeth to ache
Cheeks tender to touch
Purulent drainage
Nasal mucosa erythematous & swollen
Presence of mucoid pus
69
Q

Diagnostics of Sinusitis

A

Plain films
CT scans
MRI
Sinus aspiration

70
Q

Treatment of mild, recent onset sinusitis

A 
Rest
Plenty of fluids
Gargle with warm salt water
Throat sprays, lozenges
Petroleum jelly
Aspirin, Ibuprofen, or acetaminophen
71
Q

Treatment for Bacterial Sinusitis

A

Amoxicillin (1st line)
Augmentin
Doxycycline
Zithromax

72
Q

Self Care Measure for Sinusitis

A 
Adequate hydration
Steamy shower
Increase humidity in home
Warm facial packs
Analgesics
Decongestants
Saline irrigation lavage
Saline drops/sprays
Adequate rest
Sleep with head of bed elevated
Avoid cigarette smoke/dry, cool air
73
Q

Complications of a Bacterial Sinusitis

A 
Meningitis
Epidural abscess
Subdural empyema
Brain abscess
High fever
CNS symptoms
Orbital cellulitis
Orbital abscess
Cavernous sinus thrombosis
Mucocele formation
74
Q

Presentation of Allergic Rhinitis

A 
Clear rhinorrhea
Sneezing
Tearing
Eye irritation
Pruritis
Cough
Bronchospasm
Eczemetous dermatitis
75
Q

Treatment of Allergic Rhinitis

A

Antihistamines
Intranasal corticosteroids
Antileukotrienes
Immunotherapy

76
Q

Define Nasal Airway Obstruction

A

Inability to inspire and expire through the nasal passage

77
Q

Nasals Airway Obstruction

A 
One or both nostrils
Partial or complete block
Always, intermittent
Stable, worsening
Impaired respiration, smell, and taste
78
Q

Which population can nasal obstruction be life threatening?

A

Infants- obligate nose breathers

79
Q

Differential Diagnosis for Nasal Airway Obstruction

A 
Polyps
Tumors
Foreign bodies
Septal deviations
Trauma
80
Q

Define Nasal Polyps

A

Intense inflammatory reaction of the sinonasal mucosa of unknown etiology

81
Q

Polyps which block ______ can lead to chronic sinusitis?

A

Osteomeatal unit

82
Q

Imaging to diagnose nasal polyps

A

Coronal sinus CT
MRI
Water’s view X-ray

83
Q

Treatment for Nasal Polyps

A 
Topical steroids (1st line)
Antihistamines
Oral steroids
Leukotriene inhibitors
Intrapolyp steroid injections
Surgical removal
84
Q

Define Septal Deviation

A

Displacement of the nasal septum

85
Q

How do you obtain a septal deviation?

A

Trauma
Marfan syndrome
Homocystinuria
Ehlers-Danlos syndrome

86
Q

Symptoms of Septal Deviation

A 
Infections of the sinus
Sleep apnea
Snoring
Change in smell
Frequent sneezing
Difficulty breathing
87
Q

Treatment of Septal Deviation

A

Decongestants
Anti-histamines
Nasal spray
Septoplasty

88
Q

Define Septal Perforation

A

Hole or fissure in the nasal septum

89
Q

Causes of Septal Perforation

A

Cocaine
Nasal Sprays
Piercing

90
Q

Symptoms of Septal Perforation

A

Whistling when breathing
Bloody discharge
Nasal pressure
Discomfort

91
Q

Treatment of Septal Perforation

A

Usually heal without surgery

ENT (10 decks)

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