Sinus

Question 1

What is the definition of rhinosinusitis?

Answer 1

Inflammation of the nose and the sinuses

Question 2

What are the s/sx of rhinosinusitis? (4)

Answer 2

• facial pain
• hyposmia
• Fever
• Nasal obstruction

Question 3

What is the timeframe for acute rhinosinusitis?

Answer 3

Up to 4 weeks

Question 4

What is the timeframe for subacute rhinosinusitis? Chronic?

Answer 4

4-12 weeks

12+ weeks = chronic

Question 5

What is the definition of recurrent acute rhinosinusitis?

Answer 5

4 or more episodes / year

Question 6

True or false: sinusitis typically precedes rhinitis

Answer 6

False–other way around

Question 7

True or false: sinusitis without rhinitis is rare

Answer 7

True

Question 8

The mucus membrane of the nose is continuous down to what part of the respiratory pathway?

Answer 8

Tracheobronchial tree

Question 9

What are the classic s/sx of rhinitis?

Answer 9

• congestion
• Sneezing
• Itching
• Nasal d/c

Question 10

What is the usual cause of rhinitis/sinusitis?

Answer 10

viral etiology with 2/2 bacterial infection a common complication

Question 11

What are the classic signs of rhinitis/ sinusitis?

Answer 11

Discolored nasal containing PMNs

Question 12

What causes the green coloration of mucus?

Answer 12

PMN peroxidase

Question 13

Purulent d/c for more than how many days suggests bacterial rhinitis and/or rhinosinusitis?

Answer 13

5 days

Question 14

True or false: the color of the sputum is indicative of the etiology of rhinitis/sinusitis?

Answer 14

True per him

Question 15

What are the s/sx of rhinosinusitis?

Answer 15

• Nasal obstruction/congestion
• d/c / purulence
• Cough
• HA

Question 16

Which sinus in particular can cause sinus HAs?

Answer 16

Sphenoid sinuses

Question 17

True or false: There has to be hearing loss if there is fluid in the ear

Answer 17

True

Question 18

True or false: fever and/or leukocytosis is often present with chronic rhinosinusitis

Answer 18

False–uncommon

Question 19

What are the associated causes of rhinitis?

Answer 19

Seasonal allergic issues

Question 20

What type of secretions are had with allergic rhinitis?

Answer 20

Watery rhinorrhea

Repetitive sneezing

Question 21

True or false: allergic rhinitis plays a significant role in chronic rhinitis

Answer 21

True

Question 22

What is the classic presentation of a kid with large adenoids?

Answer 22

mouth breathers

Question 23

Chronic adenoiditis mimics what?

Answer 23

Rhinosinusitis and allergies

Question 24

What are the symptoms of adenoiditis?

Answer 24

• Nasal congestion
• Chronic rhinorrhea
• Chronic cough

Question 25

If a kid under four presents with s/sx consistent with sinusitis, what etiology should be suspected?

Answer 25

Adenoids

Question 26

What happens to the adenoids as we age?

Answer 26

Shrink, but not always

Question 27

What is the relationship between adenoids and the incidence of OM?

Answer 27

If take adenoids out, lowers recurrence rate of OM

Question 28

What happens to the drainage with adenoids with abx treatment?

Answer 28

d/c clears, with rapid return of drainage when off of meds

Question 29

True or false: to meet the diagnostic criteria for laryngopharyngeal reflux, kids have to be spitty

Answer 29

False

Question 30

What is the relationship between acid reflux and upper airway disease

Answer 30

Positive correlation

Question 31

What should be thought of in patients who have recurrent mucosal infections?

Answer 31

Immune deficits

Question 32

What are the three major risk factors for the development of upper airway disease in kids?

Answer 32

- Smoking - daycare - Allergen exposure

Question 33

What is the chronic lower airway condition that predispose kids to rhinosinusitis?

Answer 33

Asthma

Question 34

What are the chronic upper airway conditions that predispose kids to rhinosinusitis?

Answer 34

- Eustachian tube dysfunction - Nasal polyposis - Allergic conjunctivitis

Question 35

What is the role of sinusitis and asthma?

Answer 35

Inflammation in the nose may increase lower airway hyperresponsiveness

Question 36

How do you diagnose sinusitis?

Answer 36

- Type of nasal drainage | - Intranasal and pharyngeal exam

Question 37

What is the role of plain films in diagnosing rhinosinusitis?

Answer 37

No role

Question 38

What is the role of CT scans in diagnosing rhinosinusitis?

Answer 38

For medical failures

Question 39

True or false: WBC is usually normal with chronic sinusitis

Answer 39

True

Question 40

What is the role of MRIs in diagnosing rhinosinusitis?

Answer 40

Overkill

Question 41

What is the treatment for sinusitis?

Answer 41

-Augmentin

Question 42

What is the role of oral steroids in the treatment of sinusitis?

Answer 42

Can help calm down acute inflammation

Question 43

How fast do topical steroids work to treat rhinitis?

Answer 43

not instant, but relatively fast

Question 44

True or false: topical steroids are used only for chronic sinusitis

Answer 44

False--can be used in acute episodes as well

Question 45

What is the treatment of choice for sinusitis 2/2 allergies?

Answer 45

Oral antihistamines and Decongestants

Question 46

What are the two major types of topical decongestants for sinusitis?

Answer 46

Phenylephrine | Oxymetazoline

Question 47

When does rebound vasodilation occur with topical decongestants?

Answer 47

3 days

Question 48

How long does it take for rhinitis medicamentosa to take effect?

Answer 48

10 days - 14 days

Question 49

How severe are the risks of adenoidectomy?

Answer 49

Safe, with minimal pain and no real long term issues

Question 50

What is the medical therapy for adenoiditis?

Answer 50

Prolonged abx or topical steroids

Question 51

What is balloon tech for sinusitis?

Answer 51

Insert into sinus and blow up to dilate the bone

Question 52

What is the role of packing for sinusitis?

Answer 52

No longer done