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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

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
Alternative to oral antihistamines for intermittent AR
Topical antihistamine
26
T/F:: Goal of surgery as a treatment for allergic rhinitis is to remove the turbinates
F reduce size only
27
What is the predominantly involved sinus among children in acute sinusitis? How about in adults?
Ethmoid sinus in children Maxillary sinus in adults (maxillary > ethmoid > frontal > sphenoid)
28
Acute rhinosinusitis is an inflammatory condition involving what and lasts up to when?
involves the paranasal sinuses and linings of the nasal passages; lasts up to 4 weeks
29
How is acute bacterial rhinosinusitis diagnosed?
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
T/F: H. influenzae is commonly isolated from the maxillary sinuses of adults causing ABRS
T alongside S. pneumoniae, M. catarrhalis
31
T/F: ABRS is commonly found in patients with Wegener's granulomatosis Diagnostic criteria must include 2 or more of the ff:
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
Diagnostic tests for ABRS
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
What is the first line treatment for ABRS for a patient with no recent antimicrobial use in the past 4-6 weeks?
Amoxicillin Amoxicillin/Clavulanate Cefpodoxime proxetil Cefuroxime axetil
34
What is the first line treatment for ABRS for a patient with recent antimicrobial use in the past 4-6 weeks?
High dose Amoxicillin Amoxicillin/Clavulanate Ceftriaxone Gatifolaxin Levofloxacin Moxifloxacin
35
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?
Gatifolaxin Levofloxacin Moxifloxacin Clindamycin
36
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?
TMP-SMX Doxycyline Azithromycin Clarithromycin Erythromycin
37
Most common mechanism of acute viral rhinosinusitis It frequently affects what sinus(es)?
Impaired ventilation of the ostiomeatal unit Maxillary and ethmoid sinuses
38
T/F: Decongestants can't be given for more than 7 days
T due to risk of developing Rhinitis Medicamentosa
39
Only definitive treatment for Acute viral Rhinosinusitis
Functional Endoscopic Sinus Surgery It enlarges tight passages to drain sinuses properly
40
T/F: Cause of nasal polyps are generally unknown
T but it could be genetic, due to chronic mucosal irritation, allergic rhinitis and aspirin allergy, cystic fibrosis
41
What is the grade if polyps do not prolapse beyond the most anterior part of the middle turbinate Pharmacologic tx?
Grade 1 Intranasal corticosteroid for 4-6 wks
42
Grading of polyps that can be seen with a nasal speculum (extending below the middle turbinate) Pharmacologic tx?
Grade 2 short term systemic steroids + Intranasal corticosteroid
43
Grading of massive polyps that occlude the entire nasal cavity Pharmacologic tx?
Grade 3 Surgery
44
Alternative drug if there's no response to intranasal corticosteroid among grades 1 and 2 nasal polyps
Oral systemic steroids can be added
45
Sinuses involved in orbital complications
Ethmoid and Frontal sinuses

ENT-HNS (8 decks)

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