sinuses and thorat

Question 1

what is recurrent acute rhinosinusitis (RARS)

Answer 1

4 or more recurrent episodes annually

Question 2

what does our body do so that one nasal airway doesn’t dry more than the other

Answer 2

makes turbinates asymmetrically thick at varying times

Question 3

when do you drain the maxillary sinuses?

Answer 3

when you lay down

Question 4

what is the most common cause of rhinosinusitis?

Answer 4

allergic rhinitis

Question 5

what sinuses are more affected in children?

Answer 5

ethmoid

Question 6

what sinuses become blocked in adults?

Answer 6

maxillary or frontal

Question 7

complications of untreated rhinosinusitis

Answer 7

osteomyelitis, orbital cellulitis, cavernous sinus thrombophlebitis, intracranial suppuration

Question 8

most common location for retinal detachment

Answer 8

superior temporal region

Question 9

how long is chronic sinusitis

Answer 9

over 12 weeks

Question 10

what are indications for endoscopic sinus surgery

Answer 10

symptoms of CRS and recurrent acute rhinosinusitis

Question 11

what should be done before sinus surgery

Answer 11

Coronal CT scan
MRI is good for erosion of the orbital bone
allergy testing
eosinophil counts

Question 12

Ideal for patients who fail medical therapy but do not want or are unable to have sinus surgery.
Conservative approach that preserves future treatment options

Answer 12

balloon treatments

Question 13

hereditary hemorrhagic dz associated with Telangiectasias of lips, nasal mucosa, tongue

Answer 13

Osler-Weber-Rendu (hereditary hemorrhagic)

Question 14

what are some bleeding disorders than can cause epistaxis

Answer 14

idiopathic thrombocytopenia purpura
von Willebrand’s disease
Hemophilia

Question 15

Often bilateral bleeding or down into oropharynx. Brisk arterial bleeding.. More common in older adults.

Answer 15

posterior nose bleed

Question 16

tx for anterior epistaxis

Answer 16

cocaine
lidocaine
silver ntirate cautery
surgicel and packing

Question 17

tx for posterior epistaxis

Answer 17

Vasoconstriction with cocaine solution or oxymetazoline

Cautery, tamponade, pack, arterial embolization

Question 18

caused by overuse of nasal decongestants

Answer 18

Rhinitis medicamentosa

Question 19

what drugs are associated with rhinitis?

Answer 19

ACEI, beta blockers

NSAIDS

Question 20

what is the 2nd option if a patient doesn’t respond well to an antihistamine?

Answer 20

nasal corticosteroid

Question 21

what is more effective- antihistamine or nasal corticosteroid

Answer 21

nasal corticosteroid

Question 22

where should you aim the nasal corticosteroid towards?

Answer 22

The ear on that side (outward) better distribution

Question 23

with significant nasal polyposis or severe symptoms what can you do?

Answer 23

short courses with prednisone

Question 24

what is good for exercise and gustatory rhinitis

Answer 24

intranasal cromolyn

Question 25

if a person has allergic rhinitis and has failed intranasal corticosteroids

Answer 25

ipratropium bromide

Question 26

what are non-infectious causes of pharyngitis

Answer 26

chronic sinus drainage

GERD

Question 27

Tx for Peritonsillar abscess

Answer 27

I and D (best choice) or high dose abx

Question 28

Viral causes of infectious pharyngitis

Answer 28

Adenovirus, parainfluenza, rhinovirus

Epstein-Barr

Question 29

(herpangina) with tonsillar pillar/soft palate vesicles/ulcers

Answer 29

Coxsackie A

Question 30

is presence of exudates diagnostic for GAS pharyngitis?

Answer 30

No, can be other causes

Question 31

what is the most common cause of pharyngitis?

Answer 31

S. pyogenes

Question 32

Pseudomembrane (whitish, blue) on back of throat

Answer 32

Corynebacterium diphtheriae

Question 33

Tx for GABHS?

Answer 33

amoxicilin

Question 34

main reason for false negative on rapid strep antigen test

Answer 34

eat within 15 minutes

shouldn’t eat for about an hour before

Question 35

what is the Centor criteria for strep?

Answer 35

tonsillar exudate
tender anterior cervical LAD
hx of fever
absence of cough 
(need at least 3 of 4 present)

Question 36

if a person has 2 or more of the centor criteria what should you do?

Answer 36

rapid strep , only treat positives

Question 37

how are vocal cord nodule seen?

Answer 37

symmetrical

Question 38

if you see the false and normal vocal cords vibrating what do you dx them with?

Answer 38

vocal cord dysfunction, send to speech therapy

Question 39

77 year old male with 60 pack year history, GERD, and new onset hoarseness, what is at the top of your list?

Answer 39

Cancer

Question 40

15 year old cheerleader with GERD has new onset onset hoarseness what do you suspect?

Answer 40

overuse and combo of GERD

Question 41

45 y/o man, leader in church, 2 weeks ago and was unable to speak. Had been losing voice intermittently and has anxiety. Deviated nasal septum, elongated soft palate and uvula.

Answer 41

allergic rhinitis

Question 42

tx for turbinate hypertrophy

Answer 42

tubinoplasty

Question 43

what association should you make with turbinate hypertophy

Answer 43

allergic rhinitis

Question 44

when you take a deep breath and the vocal cords close off

Answer 44

spasmodic dysphonia

Question 45

tx for laryngospasm (spasmodic dysphonia)

Answer 45

speech therapy, help prevent spasm of vocal folds

Question 46

what is laryngospasm associated with

Answer 46

anxiety