Sinusitis

Question 1

What are the four sinuses in humans?

Answer 1

Frontal
ethmoidal
sphenoidal
maxilliary

Question 2

True or False: The frontal sinus drains against gravity?

Answer 2

FALSE
it is the maxillary sinus

Question 2

True or False: The frontal sinus drains against gravity?

Answer 2

FALSE
it is the maxillary sinus

Question 3

What are the criteria for recurrent sinusitis?

Answer 3

3 or more episodes in a year

Question 4

What is the physiological cause of sinusitis?

Answer 4

Blockage or inflammation of osteomeatal complex block clearance
this new environment makes it more susceptible to infection

Question 5

What are some predisposing facts for sinusitis?

Answer 5

Immunocompromised
Forgein bodies
fractured nose
polyps
asthma/allergies

Question 6

What are some predisposing facts for sinusitis?

Answer 6

Immunocompromised
Forgein bodies
fractured nose
polyps
asthma/allergies

Question 7

How long do viral cases of sinusitis last?

Answer 7

10 days

Question 8

What viruses can cause sinusitis?

Answer 8

rhino, adeno, coronaviruses

Question 9

What are the signs and Symptoms of sinusitis?

Answer 9

Purulent nasal discharge
congestion
tenderness
fever

Question 10

True or False: Children rarely get sinusitis

Answer 10

TRUE

Question 11

What criteria must be met for sinusitis to be labeled Bacterial in children?

Answer 11

purulent discharge and unwell state(fever, cough) for at least 10 days with no improvement

Question 12

When do we consider bacterial sinusitis in children to be severe?

Answer 12

If severely ill
dischage
greater than 39 fever for greater than 3 days

Question 13

What criteria must be met to h be bacterial sinusitis in adults?

Answer 13

Symptoms of URTI, congestion, facial pain for longer than 14 days

Question 14

True or false: Green nasal discharge is indicative of bacterial infection.

Answer 14

FALSE

Question 15

What is the ONLY way to distinguish between viral and bacterial sinusitis?

Answer 15

length of time-Must be no improvement after 10 days to be bacterial

Question 16

What organisms are the general cause of sinusitis?

Answer 16

MOSTLY VIRAL
S. pneumoniae= 30-60%
H. influenzae= 20 %
M. catarrhalis= 2-20%

Question 16

What organisms are the general cause of sinusitis?

Answer 16

MOSTLY VIRAL
S. pneumoniae= 30-60%
H. influenzae= 20 %
M. catarrhalis= 2-20%

Question 17

What are the anaerobic culprits of Sinusitis?

Answer 17

WHO THE FUCK KNOWS

Question 18

What are some non-drug measures for the treatment of sinusitis?

Answer 18

Steam
fluids
avoid irritants

Question 19

What role do decongestants play in Sinusitis?

Answer 19

NOTHING

Question 20

What role does intranasal steroids play in sinusitis?

Answer 20

helpful in chronic

Question 21

What is the first-line agent for Adult Bacterial Sinusitis?

Answer 21

Amoxicillin 500mg-1000mg TID

Question 22

What second-line agents can we use for adult bacterial sinusitis?

Answer 22

Amox/clav 500mg TID
2nd Gen
Doxycycline
clarithromycin or azithromycin

Question 23

What agents are used third line for adult sinusitis?

Answer 23

Levofloxacin 500mg OD moxifloxacin 400mg OD

Question 24

What is the recommended duration of antibiotic treatment for adult sinusitis? What about for kids?

Answer 24

5 days for adult 10 for kids

Question 25

What antibiotic do we give to people with chronic sinusitis?

Answer 25

Caused by anaerobes so Amox/clav or clindamycin will work

Question 26

What first-line agents can we use for kid bacterial sinusitis?

Answer 26

Amoxicillin 90mg/kg/day divided BID or TID

Question 27

What second-line agents can we use for kid bacterial sinusitis?

Answer 27

Amox/clav 90mg/kg/d divided BID cefuroxime 40 mg/kg divided BID cefprozil 30 mg/kg/d divided BID

Question 28

What third-line agents can we use for kid bacterial sinusitis?

Answer 28

clarithromycin 15 mg/kg/d divided BID azithromycin TMP/SMX 10 mg/kg/d divided BID