nose triggers

Question 1

can be caused by:
Viral URI (MC)
Allergic rhinitis
NG tube
dental infections

Answer 1

acute bacterial sinusitis

Question 2

what sinus is affected w pain on the vertex of the head

Answer 2

sphenoid

Question 3

pain with palpation just below medial portion of eyebrows is likely which sinus

Answer 3

frontal

Question 4

unilateral face pressure and tenderness with pain referred to incisor or canine teeth

Answer 4

maxillary sinus pain

Question 5

tx with augmentin is seen in which diagnoses

Answer 5

• acute bacterial rhinosinusitis
• chronic sinusitis
• epistaxis to prophylactically tx toxic shock

Question 6

tx w augmentin.
if anaphylaxis to PCN use doxy, levo, moxi or azithro

Answer 6

acute bacterial rhinosinusitis

Question 7

tx with augmentin, if non-severe PCN allergy use cinda + cefixime or cefpodoxime.

Answer 7

acute bacterial rhinosinusitis

Question 8

intranasal corticosteroids

Answer 8

acute bacterial rhinosinusitis
chronic sinusitis
mod-severe allergic rhinitis

Question 9

black eschar on middle turbinate

Answer 9

invasive fungal sinusitis

Question 10

CN V and VII involvement in severe cases

Answer 10

invasive fungal sinusitis

Question 11

long standing unilateral symptoms, non-specific mucosal changes on CT with opacification of a single sinus

Answer 11

Mycetoma (chronic fungal sinusitis)

Question 12

biopsy from nasal endoscopy and CT to determine extent of disease

Answer 12

Chronic fungal sinusitis

Question 13

treated with IC amphotericin B then after 3-6 months switch to itraconazole

Answer 13

chronic fungal sinusitis

Question 14

risk factors include hx of nasal polyposis, asthma, and sinus surgeries

Answer 14

allergic fungal sinusitis

also caused by:
high levels of IgE in body
fungus allergy

Question 15

endoscopic sinus surgery to remove debris followed by 3 months of systemic steroids

Answer 15

allergic fungal sinusitis

Question 16

causes inflammation of the blood vessels

Answer 16

wegener’s ganulomatosis

Question 17

symptoms include joint aches, blood in urine, cough, fever, hearing loss and sinus pain

Answer 17

Wegener’s granulomatosis

Question 18

saddle-nose deformity

Answer 18

wegener’s granulomatosis

Question 19

purulent bloody discharge, nasal crusting, smell disturbances, sinus pain

Answer 19

wegener’s granulomatosis d/t blood flow reduced to nose

Question 20

diagnostics include PFT, CT sinus, CXR, rheumatology workup and a biopsy

Answer 20

wegener’s granulomatosis

Question 21

treated with steroids and immunosuppressants

Answer 21

wegener’s granulomatosis

Question 22

cobblestoning of pharynx

Answer 22

allergic rhinitis

Question 23

nasal mucosa that is pale, bluish hue and boggy d/t venous engorgement

Answer 23

allergic rhinitis

Question 24

what could increase obstructive symptoms in allergic rhinitis

Answer 24

nasal polyps

Question 25

nasal secretion biopsy serum IgE level

Answer 25

Allergic rhinitis diagnostics also allergy skin testing Nasal secretion will show EOSINOPHILS

Question 26

which testing requires refrainment form antihistamines

Answer 26

skin allergy test NOT teh IgE one!

Question 27

when are antihistamines preferred

Answer 27

2ng gen antihistamines used in mild intermittent allergic rhinitis

Question 28

nasal irrigation intranasal steroids augmentin

Answer 28

chronic sinusitis

Question 29

2nd gen antihistamines

Answer 29

all end in dine or zine Cetirizine (Zyrtec) Loratadine (Claritin) Fexofenadine (Allegra) Desloratadine (Clarinex) Levocetirizine (Xyzal)

Question 30

nasal antihistamines

Answer 30

azelastine olopatadine

Question 31

avoid in narrow angle glaucoma, CVD, CAD, HTN hypothyroidism and urinary retention

Answer 31

sudafed

Question 32

has risks of rebound vasodilation and rhinitis medicamentosa

Answer 32

phenylephrine/oxymetazoline

Question 33

Insomnia, tremor, tachycardia, HTN are all common side effects of what

Answer 33

decongestants (sudafed or phenylephrine/oxymetazoline)

Question 34

combo drugs for allergic rhinitis

Answer 34

claritin D and allegra D antihistamine + sudafed

Question 35

Neuropsychiatric changes such as dreams, insomnia, anxiety, depression, suicidal thinking

Answer 35

montelukast SE

Question 36

what are the leukotriene antagonists

Answer 36

leukotrienes, montelukast,

Question 37

what is the anticholinergic used in allergic rhinitis

Answer 37

ipratropium bromide usually combined with intranasal steroids

Question 38

CI in CVD, uncontrolled asthma, BB use

Answer 38

allergy shots. only for severe allergic rhinitis

Question 39

what is the MOA of the allergy shots

Answer 39

slowly introduce small amounts of allergins into the tissues and over the course of 3-5 years desensitize the patient to allergens

Question 40

bilateral nose bleed

Answer 40

posterior epistaxis

Question 41

kiesselbacks plexus

Answer 41

MC area of anterior epistaxis

Question 42

silver nitrate or lidocaine + epi

Answer 42

anterior epistaxis. can also use nasal packing or cocaine

Question 43

narcotic analgesics

Answer 43

posterior epistaxis

Question 44

ligation of nasal arterial supply

Answer 44

posterior epistaxis

Question 45

augmentin, clinda and keflex used for...

Answer 45

ABX prophylaxis in nasal packing for toxic shock syndrome

Question 46

Pale, edematous, mucosally covered masses.

Answer 46

nasal polyps

Question 47

indicative of cystic fibrosis when found in children

Answer 47

nasal polyps

Question 48

topical nasal steroids 1-3 months followed by oral steroids. if no change surgery is indicated

Answer 48

nasal polyps

Question 49

presents with persisten unilateral epistaxis and foul smelling, copious rhinorrhea

Answer 49

nasal foreign body