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ENT-HNS > Rhinorrhea > Flashcards

Rhinorrhea Flashcards

1
Q

This part of the respiratory mucosa is composed of basal cells, goblet cells, cells that produce mucus, and ciliary cells that propels mucus backwards

A

Epithelium

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2
Q

This nerve primary supplies for sensory innervation. It is a branch of the pterygopalatine ganglion

A

Trigeminal Nerve

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3
Q

Cilia moves at a frequency of ___ beats/min to move the mucosa.

Mucus envelopes the nose from the environment, with a stream rate of ___ ml/min

A

10-15 beats/min
2.5-7.5 mL/min

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4
Q

T/F: Venous erectile tissue is abundant in the superior turbinate

A

F
It is abundant in the inferior turbinate

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5
Q

T/F: During expiration, the moisture and heat is returned to the nose via condensation

A

T

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6
Q

Most important mechanical defense of the nose

A

Mucociliary Apparatus

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7
Q

Immune cell involved in allergic rhinitis

A

Mast cells

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8
Q

T/F: Autonomic nervous system regulates the mucosal vasculature and glandular secretions

A

T

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9
Q

Effect of neuropeptide Y in the nasal reflex arc

A

Vasoconstriction as it is sympathetic

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10
Q

Effect of acetylcholine in the nasal reflex arc

A

increased mucus secretions

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11
Q

What is the pathophysiology of acute rhinitis?

A

Viruses like influenza and coronavirus enter the nose, damage the epithelium and the mucociliary transport system, thus promoting bacterial (?) colonization

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12
Q

T/F: Topical decongestants must be used for at least 2 weeks to take effect against acute rhinitis

A

F
It must not be used for more than 1 week to avoid rebound congestion

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13
Q

2 stages of acute rhinitis

A

Dry stage
Catarrhal stage

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14
Q

This stage of acute rhinitis causes malaise and local discomfort of the nose and nasopharynx

A

Dry stage

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15
Q

This stage of acute rhinitis causes watery/serous nasal discharge and nasal obstruction

A

Catarrhal stage

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16
Q

5 types of Non-allergic Rhinitis

A

Vasomotor rhinitis
Idiopathic rhinitis
Gustatory Rhinitis
Hormonal Rhinitis
Atrophic Rhinitis

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17
Q

This non-allergic rhinitis is a neurovascular autonomic disturbance in regulating the tonus of the nasal mucosa

A

Vasomotor rhinitis

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18
Q

What makes you feel symptoms if you have vasomotor rhinitis?

A

Temperature changes
Drinking hot liquid or alcohol
Perfumes
Emotional stress

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19
Q

In this non-allergic rhinitis, there is mucus gland hyperactivity. Nasal douche or neti pots serve as treatment

A

Hormonal Rhinitis

20
Q

T/F: Among pregnant women, low estrogen = less nasal congestion

A

T

21
Q

This condition is a side effect of long term use of topical nasal decongestants, with daily usage in a span of ____

What are the signs and symptoms of this condition?

A

Rhinitis Medicamentosa
1 year

Obstructive nasal breathing, dry mucosa, and occasional olfactory disturbances

22
Q

What is atrophic rhinitis?

What is its pathophysiology?

A

It is characterized by pronounced dryness of the nasal mucosa, with fetid nasal odor

There is non-functional lining of nonciliated squamous metaplasia and loss of mucociliary clearance and neurologic regulation usually due to removal of lining of the nose during nose surgeries

23
Q

What is the treatment for persistent AR not responsive to topical steroids for 1 month?

A

Short course oral steroids

24
Q

What is the treatment for severe AR symptoms?

A

Short course oral steroids

25
Q

Alternative to oral antihistamines for intermittent AR

A

Topical antihistamine

26
Q

T/F:: Goal of surgery as a treatment for allergic rhinitis is to remove the turbinates

A

F
reduce size only

27
Q

What is the predominantly involved sinus among children in acute sinusitis?
How about in adults?

A

Ethmoid sinus in children
Maxillary sinus in adults (maxillary > ethmoid > frontal > sphenoid)

28
Q

Acute rhinosinusitis is an inflammatory condition involving what and lasts up to when?

A

involves the paranasal sinuses and linings of the nasal passages; lasts up to 4 weeks

29
Q

How is acute bacterial rhinosinusitis diagnosed?

A

It is diagnosed among adults with symptoms of a viral upper respiratory infection that has not improved after 10 days or worsen after 5-7 days

30
Q

T/F: H. influenzae is commonly isolated from the maxillary sinuses of adults causing ABRS

A

T
alongside S. pneumoniae, M. catarrhalis

31
Q

T/F: ABRS is commonly found in patients with Wegener’s granulomatosis

Diagnostic criteria must include 2 or more of the ff:

A

T
as it causes inflammation in various tissues in the respiratory tract

Nasal blockage or congestion, anterior and/or posterior purulent drainage, facial pain/pressure/fullness, hyposmia or anosmia

32
Q

Diagnostic tests for ABRS

A

Sinus puncture of culture aspiration
PNS Xray
CT scan (more accurate than MRI) to look at sinuses
MRI- if there is neoplastic or fungal process

33
Q

What is the first line treatment for ABRS for a patient with no recent antimicrobial use in the past 4-6 weeks?

A

Amoxicillin
Amoxicillin/Clavulanate
Cefpodoxime proxetil
Cefuroxime axetil

34
Q

What is the first line treatment for ABRS for a patient with recent antimicrobial use in the past 4-6 weeks?

A

High dose Amoxicillin
Amoxicillin/Clavulanate
Ceftriaxone
Gatifolaxin
Levofloxacin
Moxifloxacin

35
Q

What is the alternative treatment for ABRS for a patient with recent antimicrobial use in the past 4-6 weeks and is allergic to beta lactams?

A

Gatifolaxin
Levofloxacin
Moxifloxacin
Clindamycin

36
Q

What is the alternative treatment for ABRS for a patient with no antimicrobial use in the past 4-6 weeks and but is allergic to beta lactams?

A

TMP-SMX Doxycyline
Azithromycin
Clarithromycin
Erythromycin

37
Q

Most common mechanism of acute viral rhinosinusitis

It frequently affects what sinus(es)?

A

Impaired ventilation of the ostiomeatal unit

Maxillary and ethmoid sinuses

38
Q

T/F: Decongestants can’t be given for more than 7 days

A

T
due to risk of developing Rhinitis Medicamentosa

39
Q

Only definitive treatment for Acute viral Rhinosinusitis

A

Functional Endoscopic Sinus Surgery

It enlarges tight passages to drain sinuses properly

40
Q

T/F: Cause of nasal polyps are generally unknown

A

T
but it could be genetic, due to chronic mucosal irritation, allergic rhinitis and aspirin allergy, cystic fibrosis

41
Q

What is the grade if polyps do not prolapse beyond the most anterior part of the middle turbinate

Pharmacologic tx?

A

Grade 1

Intranasal corticosteroid for 4-6 wks

42
Q

Grading of polyps that can be seen with a nasal speculum (extending below the middle turbinate)

Pharmacologic tx?

A

Grade 2

short term systemic steroids + Intranasal corticosteroid

43
Q

Grading of massive polyps that occlude the entire nasal cavity

Pharmacologic tx?

A

Grade 3

Surgery

44
Q

Alternative drug if there’s no response to intranasal corticosteroid among grades 1 and 2 nasal polyps

A

Oral systemic steroids can be added

45
Q

Sinuses involved in orbital complications

A

Ethmoid and Frontal sinuses

ENT-HNS (8 decks)

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