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Head And Neck > Rhinology > Flashcards

Rhinology Flashcards

1
Q

What is a typical history of someone with a rhinological disease?

A

Nasal obstruction
Nasal discharge
Epistaxis
Facial pain
Nasal deformity
Anosmia
Sneezing

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2
Q

What is a PMH of someone with rhinological disease?

A

Medical treatment
Nasal surgery
Nasal trauma
Asthma/ aspirin sensitivity

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3
Q

What occupation an predispose rhinological disease?

A

Woodworkers

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4
Q

What social factors ca contribute to a rhinological disease?

A

Alcohol
Smoking
Cocaine abuse

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5
Q

What are some nasal disorders?

A

Nasal trauma
Rhinosinusitis
Nasal polyps
Epistaxis
Nasal deformity
Nasal tumours
Choanal atresia

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6
Q

What investigations can be done for nasal disorders?

A

Blood tests- FBC, ANCA, CRP, ACE, RAST
CT scan
MRI scan
Skin tests
Rhinomanometry

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7
Q

What is the treatment for a broken nose?

A

Within 2 weeks- reduce in clinic- give local anaesthetics- tweak bone back into position
After 2 weeks - septa-rhinoplasty operation to correct nose inside and outside

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8
Q

What can be caused by nasal trauma?

A

Septal haematoma

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9
Q

What is septal haematoma?

A

Blood clot between the periosteum and septum

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10
Q

What can a septal haematoma cause?

A

If not drain, can lead to blood supply to cartilaginous part of septum not getting enough blood -> necrosis -> septic perforation -> deformity

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11
Q

What can nasal polyps predispose?

A

Asthma

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12
Q

Which symptoms should be present to diagnose acute sinusitis?

A

One of either:
Nasal blockage/ obstruction/congestion
Or nasal discharge: anterior/ post nasal drip:
+/- facial pain/ pressure
+/- reduction or loss of smell

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13
Q

What symptoms suggest an immediate referral/ hospitalisation?

A

Periorbital oedema
Displaced globe
Double vision
Ophthamoplegia
Reduced Vision acuity
Severe unilateral or bilateral frontal headache
Frontal swelling
Signs of meningitis or focal neurological signs

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14
Q

What is the most common bacteria causing acute bacterial rhinosinusitis?

A

S. Pneumoniae

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15
Q

What is the second most common bacteria causing rhinosiusitis?

A

H. Influenzae

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16
Q

What is the treatment for acute rhinosinusitis?

A

Conservative treatment
Antibiotics rarely given in CRS
-B-lactams- penicillins, cephalosporins
-macrolides- e.g. erythromycin, clarithromycin

17
Q

What criteria needs to be met to diagnose chronic rhinosinusitis?

A

The following of at least 2 of the following symptoms for at least 12 consecutive weeks:
Nasal obstruction
Nasal drainage
Facial pain/ pressure
Hypos is/ ansomia
And
Objective evidence on physical exam ( e.g. mucopurulent drainage, oedema, polyps in the middle meatus) or radiography (preferably sinus computed tomography)

18
Q

A 10YR old presents with acute periorbital swelling and acute URI, what are the treatment options?

A

Emergency referral
Ophthalmic opinion
Urgent CT
IV antibiotics
Emergency surgery

19
Q

What is the first line management for frontal sinusitis/ Potts puffy tumour?

A

Emergency referral
Frontal sinus surgery
ESS

20
Q

How does frontal sinusitis present?

A

Acute onset fever
Frontal headache
Nasal discharge

21
Q

What occurs in mucocele?

A

Sinus not draining
Swollen sinus
Mucous collecting-> pushing eye downwards

22
Q

How is ethmoidal mucocele treated

A

FESS

23
Q

How does nasal polyps present?

A

Constant blocked nose
PN drip
Hyposmia
(History of asthma and aspirin sensitivity)

24
Q

What is the cause of nasal polyps?

A

Unknown
Chronic inflammation?
Autonomic nervous system dysfunction?
Genetic predisposition?

25
Q

What is nasal polyps secondary to?

A

Cystic fibrosis
AFS
Churn-Strauss syndrome

26
Q

What is the investigation of nasal polyps?

A

Sweat test
RAST/ skin testing
Nasal smear
-microbiology
-eosinophils
-neutrophils
CT scan
MRI scan
Flexible nasendoscopy
Rigid nasendoscopy

27
Q

What is the treatment of nasal polyps?

A

Oral and nasal steroids
Immunotherapy
Diet

28
Q

What is the surgical treatment of nasal polyps?

A

Traditional polypectomy
Endoscopic sinus surgery
Medical treatment long term

29
Q

What factors should you consider with nose bleeds?

A

Congenital
Traumatic
Inflammatory
Infective
Neoplastic

30
Q

What are the causes of epistaxis

A

Idiopathic
Infection
Trauma
Allergy
Hypertension and atherosclerotic vascular disease
Hereditary hemorrhagic telangiectasia
Blood dyscrasia
Strophic rhinitis
Tumour
Congenital or acquired nasal defects

31
Q

What are infective causes of epitaxis?

A

Rhinitis
Nasopharyngitis
Sinusitis

32
Q

What are traumatic causes of epitaxis?

A

Accidental or self induced
Iatrogenic

33
Q

What are blood dyscrasias causes of epitaxis?

A

Iatrogenic (drug induced)
Disease mediated
Alcoholism

34
Q

What is the treatment of epitaxis?

A

ABCs
Medical history/ medications
Vital signs -need if
Physical exam (anterior rhinoscopy and endoscopic rhinoscopy_
Lab exam

35
Q

What is the surgical treatment for epitaxis?

A

Endoscopic sphenopalatine artery ligation
Transmaxillary IMA ligation
Intraoral IMA ligation
Anterior/posterior ethmoidal ligation
External carotid artery ligation

Laser coagulation
Youngs procedure
Septodermoplasty

Embolisation

36
Q

How is angiofibroma treated?

A

Preoperative embolisation
Surgery

37
Q

What is the treatment for nasal tumour?

A

Radiotherapy and surgery combined

38
Q

How does a nasal tumour present?

A

Left/ right sided hearing loss and mild epitaxis - 3 months

Head And Neck (9 decks)

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