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respiratory > Rhinosinusitis - epistaxis - DVT/PE > Flashcards

Rhinosinusitis - epistaxis - DVT/PE Flashcards

1
Q

epistaxis

A

nose bleeding

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2
Q

epistaxis - MC occurs in (area)

A

anterior segment of nostril (KIESSELBACH PLEXUS)

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3
Q

epistaxis - life threatening

A

life threatening haemorrhages occurs in posterior segment of nostril (sphenopalatine artery, a branch of maxillary artery)

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4
Q

posterior segment of nostril epistaxis

A

life threatening hemorrhages (sphenopalatine artery, a branch of maxillary artery)

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5
Q

Rhinosinusitis pathophysiology

A

obstruction of sinus drainage into nasal cavity –> inflammation and pain over affected area

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6
Q

Rhinosinusitis symptoms

A
  1. pain over affected area

2. Maybe loss of smell

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7
Q

MC acute cause of Rhinosinusitis

A

viral URI

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8
Q

Rhinosinusitis MAY CAUSE

A

superimposed bacterial infection, most commonly by

a. S. pneumonia
b. H. influenza
c. M catarrhalis

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9
Q

Typical area for Rhinosinusitis

A

maxillary sinuses, which drain into middle meatus, in adults

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10
Q

Rhinosinusitis - what may show in CT

A

nasal septal deviation

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11
Q

deep venous thrombosis - definition

A

blood clot within a deep vein

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12
Q

deep venous thrombosis - symptoms

A
  1. swelling
  2. redness
  3. warmth
  4. pain
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13
Q

deep venous thrombosis is predisposed by

A

Virchow triad

  1. stasis
  2. hypercoagulability
  3. Endothelial damage
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14
Q

virchow triad - endothelial damage

A

exposed collagen triggers clotting cascade

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15
Q

virchow triad - hypercoagulability

A

defect in coagulation cascade proteins, such as factor V Leiden

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16
Q

Homan sign

A

DVT

dorsiflexion of foot –> calf pain

17
Q

most of pulmonary emboli arise from ….

proportion?

A

proximal deep veins of lower extremity

95%

18
Q

prophylaxis and acute management of DVT

A

unfractionated heparin
OR
low molecular weight heparin

19
Q

treatment (long time prevention) of DVT

A

oral anticoagulants (e.g. warfarin, rivaroxaban)

20
Q

imaging study for pulmonary emboli

look for

A

CT pulmonary angiography

look for filling defects

21
Q

Pulmonary emboli - CT pulmonary angiography

look for

A

filling defects

22
Q

types/causes of pulmonary emboli

A

mnemomic: FAT BAT

1. Fat 2. Air 3. Thrombus 4. Bacteria 5. Amnionionic fluid 6. Tumor

23
Q

pulmonary emboli symptoms

A
  1. sudden onset of dyspnea
  2. chest pain
  3. tachypnea
  4. tachycardia
  5. SUDDEN DEATH
24
Q

air emboli pathophysiology

A

nitrogen bubbles precipitate in ascending divers (caison disease, decompression sickness)

25
Q

air emboli treatment

A

hyperbaric O2

26
Q

fat emboli - situations

A
  1. long bone fractures

2. liposuction

27
Q

fat emboli - symptoms

A

classic triad:

  1. hypoxemia
  2. neurologic abnormalities
  3. petechial rash
28
Q

thrombi pulmonary emboli - histology

A

lines of Zahn: interdigitating areas of pink (platelets, fibrin) and red (RBCs) found only in thrombi formed before death

29
Q

lines of Zahn: pink areas

A

platelets and fibrin

30
Q

lines of Zahn: red areas

31
Q

lines of Zahn - utility

A

help distinguish pre and postmortem thrombi

32
Q

Pulmonary embolism - ph (mechanism)

A

V/Q mismatch –> hypoxemia –> respir alkalosis

33
Q

Amnionic fluid emboli can lead to (according to Lungs)

A

DIC, especially postpartum

34
Q

tumor that causes DVT

A

glucagonoma

35
Q

glucagonoma symptoms

A
  1. dermatitis (necrolytic migratory erythema)
  2. diabetes (hyperglycemia)
  3. DVT
  4. Depression
36
Q

Head and neck cancer - type

A

mostly SCC

37
Q

Head and neck cancer - risk factors

A
  1. tobacco
  2. alcohol
  3. HPV-16 (oropharyngeal)
  4. EBV (nasopharyngeal
38
Q

Head and neck cancer - HPV-16 vs EBV

A

HPV-16 –> oropharyngeal

EBV –> nasopharyngeal

39
Q

Head and neck cancer - filed cancerization

A

carcinogens gamage wide mucosal area –> multiple tumors

respiratory (27 decks)

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