Rhinosinusitis (common cold/coryza)

Question 1

Rhinosinusitis, also referred to as sinusitis is inflammation of the paranasal sinuses. What is the estimated incidence of acute Rhinosinusitis?

1 - 2.5 cases per 100,000
2 - 25 cases per 100,000
3 - 250 cases per 100,000
4 - 2500 cases per 100,000

Answer 1

4 - 2500 cases per 100,000

Question 2

Rhinosinusitis, also referred to as sinusitis is inflammation of the paranasal sinuses. What age does acute Rhinosinusitis peak at?

1 - 10-20
2 - 20-30
3 - 40-50
4 - >75

Answer 2

3 - 40-50

Question 3

Is Rhinosinusitis more common in men or women?

Answer 3

• equal in both

Question 4

How long does acute Rhinosinusitis typically last for?

1 - 24h
2 - 7 days
3 - 2 weeks
4 - 4 weeks

Answer 4

4 - 4 weeks

Question 5

How long does sub-acute Rhinosinusitis typically last for?

1 - 7 days
2 - 2 weeks
3 - 1 month
4 - 1-3 months

Answer 5

4 - 1-3 months

Question 6

How long does chronic Rhinosinusitis typically last for?

1 - >4 weeks
2 - >2 months
3 - >4 months
4 - >6 months

Answer 6

3 - >4 months

Question 7

All of the following are paranasal sinuses that help amplify your voice, if blocked your voice sound changes. Which of the following are above the eyes?

1 - frontal sinuses
2 - ethmoidal sinuses
3 - sphenoidal sinuses
4 - maxillary sinuses

Answer 7

1 - frontal sinuses

Question 8

All of the following are paranasal sinuses that help amplify your voice, if blocked your voice sound changes. Which of the following are below the eyes?

1 - frontal sinuses
2 - ethmoidal sinuses
3 - sphenoidal sinuses
4 - maxillary sinuses

Answer 8

4 - maxillary sinuses

Question 9

All of the following are paranasal sinuses that help amplify your voice, if blocked your voice sound changes. Which of the following are behind the eyes?

1 - frontal sinuses
2 - ethmoidal sinuses
3 - sphenoidal sinuses
4 - maxillary sinuses

Answer 9

2 - ethmoidal sinuses

Question 10

All of the following are paranasal sinuses that help amplify your voice, if blocked your voice sound changes.Which of the following are above the pharynx and infront of the ears?

1 - frontal sinuses
2 - ethmoidal sinuses
3 - sphenoidal sinuses
4 - maxillary sinuses

Answer 10

3 - sphenoidal sinuses

Question 11

The nasal cavity is lined by hairs that are lined by mucus. Which of the following is not a characteristic of mucus?

1 - salty
2 - sticky
3 - lysozyme containing
4 - macrophage containing

Answer 11

4 - macrophage containing

• lysozyme are enzymes able to degrade pathogens
• mucus collects dust, pollen and pathogens

Question 12

Which of the following is a function of the paranasal sinuses?

1 - echo our voice
2 - goblet cells that produce mucus to trap pathogens and foreign particles
3 - circulate, moisten and warm air
4 - columnar cells with cilia that can move mucus and foreign bodies
5 - all of the above

Answer 12

5 - all of the above

Question 13

The most common cause of Rhinosinusitis is an infection. Which of the following viruses can cause Rhinosinusitis?

1 - Influenzae virus
2 - Rhinoviruses
3 - Parainfluenza virus
4 - all of the above

Answer 13

4 - all of the above
all are viral

• Rhinoviruses = common cold
• Parainfluenza virus = common cold
• Haemophilus influenzae = flu

Question 14

Which bacteria commonly lead to Rhinosinusitis?

1 - Streptococcus pneumoniae
2 - Haemophilus influenzae
3 - Moraxella catarrhalis
4 - all of the above

Answer 14

4 - all of the above

Question 15

Allergic rhinitis is an IgE inflammatory disorder of the nose caused by sensitisation of nasal mucosa to allergens. What symptoms can this present with?

1 - sneezing
2 - nasal itching
3 - discharge/congestion
4 - all of the above

Answer 15

4 - all of the above

Question 16

Allergic rhinitis is an IgE inflammatory disorder of the nose caused by sensitisation of nasal mucosa to allergens. Which of the following is NOT typically a complication of allergic rhinitis?

1 - impaired school performance
2 - disturbed sleep
3 - cystic fibrosis
4 - asthma
5 - sinusitis and nasal polyps

Answer 16

3 - cystic fibrosis

Question 17

Are paranasal sinuses typically sterile or non-sterile?

Answer 17

• sterile

Question 18

Which of the following is NOT a predisposing factors to Rhinosinusitis?

1 - nasal obstruction (septal deviation or nasal polyps)
2 - recent local infection (rhinitis or dental extraction)
3 - swimming/diving
4 - COPD
5 - smoking

Answer 18

4 - COPD

Question 19

In acute Rhinosinusitis there is a foreign body that causes an inflammatory response. Goblet cells increase mucus production leading to congestion and immune cells attack foreign body forming pus. Which of the following is NOT a component of this pus?

1 - immune cells
2 - dead tissue
3 - blood
4 - foreign body

Answer 19

3 - blood

Question 20

In some patients with Rhinosinusitis, this can become chronic and progress into chronic hyperplastic Rhinosinusitis, which leads to what?

1 - connective tissue in paranasal sinuses proliferate quicker than usual forming polyps
2 - connective tissue proliferates and becomes malignant
3 - paranasal sinuses collapse on themselves
4 - connective tissue proliferates leading to increased sign of paranasal sinuses

Answer 20

1 - connective tissue in paranasal sinuses proliferate quicker than usual forming polyps

Question 21

Are the polyps that can form in chronic hyperplastic Rhinosinusitis cancerous or benign?

Answer 21

• benign

Question 22

Which of the following is NOT a clinical symptom of Rhinosinusitis?

1 - facial pain, typically frontal and worse when leaning forward
2 - blurred vision
3 - pressure in the face
4 - headaches
5 - change in voice, smell and taste
6 - cough when lying down

Answer 22

2 - blurred vision

All are typically caused by excessive mucus

Question 23

Diagnosis of Rhinosinusitis is typically clinical, but which 2 of the following can be useful for diagnosis?

1 - head CT
2 - raised ESR and CRP
3 - rhinoscopy
4 - X-ray

Answer 23

1 - head CT
3 - rhinoscopy

Question 24

When treating Rhinosinusitis, including allergic rhinitis, all of the following should be used EXCEPT which one?

1 - analgesia
2 - intranasal decongestants or nasal saline
3 - oral antivirals
4 - corticosteroids if symptoms >10 days (given nasally or orally)
5 - oral antibiotics
6 - avoid allergens where possible

Answer 24

3 - oral antivirals

Oral antibiotics can be used in high risk populations

Surgery to open airways and sinuses may also be useful