Sinus Flashcards
What is the definition of rhinosinusitis?
Inflammation of the nose and the sinuses
What are the s/sx of rhinosinusitis? (4)
- facial pain
- hyposmia
- Fever
- Nasal obstruction
What is the timeframe for acute rhinosinusitis?
Up to 4 weeks
What is the timeframe for subacute rhinosinusitis? Chronic?
4-12 weeks
12+ weeks = chronic
What is the definition of recurrent acute rhinosinusitis?
4 or more episodes / year
True or false: sinusitis typically precedes rhinitis
False–other way around
True or false: sinusitis without rhinitis is rare
True
The mucus membrane of the nose is continuous down to what part of the respiratory pathway?
Tracheobronchial tree
What are the classic s/sx of rhinitis?
- congestion
- Sneezing
- Itching
- Nasal d/c
What is the usual cause of rhinitis/sinusitis?
viral etiology with 2/2 bacterial infection a common complication
What are the classic signs of rhinitis/ sinusitis?
Discolored nasal containing PMNs
What causes the green coloration of mucus?
PMN peroxidase
Purulent d/c for more than how many days suggests bacterial rhinitis and/or rhinosinusitis?
5 days
True or false: the color of the sputum is indicative of the etiology of rhinitis/sinusitis?
True per him
What are the s/sx of rhinosinusitis?
- Nasal obstruction/congestion
- d/c / purulence
- Cough
- HA
Which sinus in particular can cause sinus HAs?
Sphenoid sinuses
True or false: There has to be hearing loss if there is fluid in the ear
True
True or false: fever and/or leukocytosis is often present with chronic rhinosinusitis
False–uncommon
What are the associated causes of rhinitis?
Seasonal allergic issues
What type of secretions are had with allergic rhinitis?
Watery rhinorrhea
Repetitive sneezing
True or false: allergic rhinitis plays a significant role in chronic rhinitis
True
What is the classic presentation of a kid with large adenoids?
mouth breathers
Chronic adenoiditis mimics what?
Rhinosinusitis and allergies
What are the symptoms of adenoiditis?
- Nasal congestion
- Chronic rhinorrhea
- Chronic cough
If a kid under four presents with s/sx consistent with sinusitis, what etiology should be suspected?
Adenoids
What happens to the adenoids as we age?
Shrink, but not always
What is the relationship between adenoids and the incidence of OM?
If take adenoids out, lowers recurrence rate of OM
What happens to the drainage with adenoids with abx treatment?
d/c clears, with rapid return of drainage when off of meds
True or false: to meet the diagnostic criteria for laryngopharyngeal reflux, kids have to be spitty
False
What is the relationship between acid reflux and upper airway disease
Positive correlation
What should be thought of in patients who have recurrent mucosal infections?
Immune deficits
What are the three major risk factors for the development of upper airway disease in kids?
- Smoking
- daycare
- Allergen exposure
What is the chronic lower airway condition that predispose kids to rhinosinusitis?
Asthma
What are the chronic upper airway conditions that predispose kids to rhinosinusitis?
- Eustachian tube dysfunction
- Nasal polyposis
- Allergic conjunctivitis
What is the role of sinusitis and asthma?
Inflammation in the nose may increase lower airway hyperresponsiveness
How do you diagnose sinusitis?
- Type of nasal drainage
- Intranasal and pharyngeal exam
What is the role of plain films in diagnosing rhinosinusitis?
No role
What is the role of CT scans in diagnosing rhinosinusitis?
For medical failures
True or false: WBC is usually normal with chronic sinusitis
True
What is the role of MRIs in diagnosing rhinosinusitis?
Overkill
What is the treatment for sinusitis?
-Augmentin
What is the role of oral steroids in the treatment of sinusitis?
Can help calm down acute inflammation
How fast do topical steroids work to treat rhinitis?
not instant, but relatively fast
True or false: topical steroids are used only for chronic sinusitis
False–can be used in acute episodes as well
What is the treatment of choice for sinusitis 2/2 allergies?
Oral antihistamines and Decongestants
What are the two major types of topical decongestants for sinusitis?
Phenylephrine
Oxymetazoline
When does rebound vasodilation occur with topical decongestants?
3 days
How long does it take for rhinitis medicamentosa to take effect?
10 days - 14 days
How severe are the risks of adenoidectomy?
Safe, with minimal pain and no real long term issues
What is the medical therapy for adenoiditis?
Prolonged abx or topical steroids
What is balloon tech for sinusitis?
Insert into sinus and blow up to dilate the bone
What is the role of packing for sinusitis?
No longer done
