Rhinology

Question 1

What are the causes of nasal polyps?

Answer 1

Unknown
Chronic inflammation
Autonomic nervous system dysfunction
Genetic predisposition
Allergic vs non-allergic

Question 2

What percentage of people with nasal polyps have asthma?

Answer 2

20-50%

Question 3

What percentage of people with nasal polyps have aspirin intolerance?

Answer 3

8-26%

Question 4

What percentage of people with nasal polyps have alcohol intolerance?

Answer 4

50%

Question 5

What non-allergic conditions are associated with nasal polyps?

Answer 5

Cystic fibrosis
AFS
Churg-strauss syndrome

Question 6

What investigations are done for nasal polyps?

Answer 6

Sweat test
RAST/skin testing
Nasal smear (microbiology, eosinophils, neutrophils)
Coronal CT scan
MRI 
Flexible nasendoscopy
Rigid nasendoscopy

Question 7

What are the treatments for nasal polyps?

Answer 7

Oral and nasal steroids (high dose prednisolone and nasal steroids)
Immunotherapy

Question 8

What is the surgical treatment for nasal polyps?

Answer 8

Polypectomy
Microdebrider
Endoscopic sinus surgery

Question 9

What is acute adult sinusitis?

Answer 9

Acute onset of symptoms
Symptoms < 12 weeks
Symptoms resolve completely

Question 10

What is recurrent acute adult sinusitis?

Answer 10

1><4 episodes of acute rhinosinusitis per year
Complete recovery between episodes
Symptom free period > 8 weeks between acute attacks

Question 11

What is chronic adult rhinosinusitis?

Answer 11

Symptoms > 12 weeks

Persistent inflammatory changes on imaging > 4 weeks

Question 12

What is acute exacerbations of chronic adult rhinosinusitis?

Answer 12

Worsening of existing symptoms or appearance of new symptoms

Complete resolution of acute (but not chronic) symptoms between episodes

Question 13

What are the 2 most common microbial causes of rhinosinusitis?

Answer 13

S. pneumoniae

H. influenzae

Question 14

What are the major factors of rhinosinusitis?

Answer 14

Facial pain + pressure
Hyposmia/anosmia
Nasal congestion/obstruction
Purulent postnasal drain
Olfactory disturbance
Cough

Question 15

What are the minor factors of rhinosinusitis?

Answer 15

Headache
Fever
Fatigue
Halitosis
Dental pain

Question 16

What are the 2 antimicrobial choices for rhinosinusitis?

Answer 16

B-lactams - penicillins, cephalosporins

Macrolides - e.g. erythromycin, clarithromycin

Question 17

What are the treatment options for acute peri-orbital swelling?

Answer 17

Emergency referral
Opthal opinion
Urgent CT
IV antibiotics
Emergency surgery

Question 18

What are the treatments for frontal sinusitis?

Answer 18

Emergency referral
Frontal sinus surgery
ESS

Question 19

What are common causes of epistaxis?

Answer 19

Infection
Trauma
Allergy
Hypertension/atherosclerotic vascular disease
Hereditary haemorrhagic telangiectasia
Blood dyscrasias
Atrophic rhinitis
Tumour
Congenital/acquired nasal defects

Question 20

What is the initial management of epistaxis?

Answer 20

ABCs
Medical history/medications
Vital signs 
Physical exam
Laboratory exam

Question 21

What are the surgical treatments for epistaxis?

Answer 21

Endoscopic sphenopalatine artery ligation
Transmaxillary IMA ligation
Intraoral IMA ligation
Anterior/posterior ethmoidal ligation
External carotid artery ligation
Septodermoplasty/laser ablation
Embolisation