Rhinology

Question 1

The only treatment proven to alter the disease course of allergic rhinitis?

Answer 1

IMMUNOTHERAPY

Question 2

Most effective combination treatment for allergic rhinitis

Answer 2

Intranasal corticosteroids and intranasal antihistamines

Question 3

Three pathways to complement activation

Answer 3

1. Classic pathway : An-Ab complex
2. Alternative pathway : microbial structures
3. Lectins pathway : Mannans (in microbial walls)

Question 4

Complement deficiency and their corresponding disease

Answer 4

1. MAC : Neisseria infections
2. C3 : pyogenic infections
3. C2/4 : lupus like syndrome
4. C1 : mast cell independent angioedema

Question 5

Has clinical phenotype of allergic rhinitis but negative skin or serologic test, positive nasal response on antigen challenge

Answer 5

Local Allergic Rhinitis

Question 6

Old classification of Allergic rhinitis and their definitions

Answer 6

1. Seasonal AR: symptoms on exposure with seasonal allergens (ragweed, grasses, outdoor molds, and tree pollens)
2. Perennial AR: Sx on exposure 2 hours/day,>9mos/year (house dust mites, indoor molds, animal dander, and cockroaches)
3. Episodic AR: Sx on exposure to allergens not usually found in environment (fur allergy)

Question 7

What comprises of the OMC?

Answer 7

1. uncinate process
2. ethmoidal infundibulum
3. hiatus semilunaris
4. anterior ethmoidal cells
5. ostia of the anterior ethmoidal, maxillary, and frontal sinuses

Question 8

Cite the Keros Classification

Answer 8

Type 1: 1-3mm
Type 2: 4-7 mm
Type 3: 8-16 mm

Question 9

3 dimensional space bounded my uncinate process medically and Latina papyracea laterally

Answer 9

Ethmoidal infundibulum

Question 10

The maxillary sinus opens into the into the infundibulum at what angle?

Answer 10

45 degree angle

Question 11

Two-dimensional slit that lies between the free edge of the uncinate process and the ethmoidal bulla

Answer 11

Hiatus semilunaris (inferior semilunar slit)

Question 12

Most anterior and most constant cell?

Answer 12

Agger nasi cell

Question 13

An anterior ethmoidal cell that pneumatizes into the orbital floor, may compromise patency of ostium?

Answer 13

Halley cell | Infraorbital cell

Question 14

The sphenoid sinus ostium is located ___ cm from the nasal spine at an angle of ___ from the floor?

Answer 14

6.2-8cm ; 30-34 degrees

Question 15

Most consistent endoscopic landmark of the sphenoid ostium

Answer 15

visualization of the lower half of the superior turbinate, staying surgically below the level of the maxillary sinus roof and just over the top of the horizontal basal lamella,

Question 16

Indications for use of image guided surgery accdg to AAO HNS?

Answer 16

1. Revision surgery
2. Distorted anatomy due to developmental, post operative,trauma
3. Extensive nasal polyposis
4. Skull base defect/CSF rhinorrhea
5. Frontal, posterior ethmoid, sphenoid involving
6. Disease abutting orbit, optic nerve, ICA
7. Sinonasal neoplasms