Sinusitis Flashcards
1
Q
Define acute rhinosinusitis
A
- Rapid onset inflammation of nose and paranasal sinuses +
Nasal blockage or nasal discharge
Facial pain or pressure
Reduction/loss of smell
2
Q
Commonest cause of acute rhinosinusitis
A
- Viral
3
Q
When can bacterial occur
A
Usually as result of viral immunocompromised Odontogenic infection Deficient mucociliary clearance Mechanical nasal obstruction
Usually S pneumoniae
Severe fungal in immunocompromised/diabetic
4
Q
Management of uncomplicated acute viral rhinosinusitis
A
- Usually for 7-10 days
- Adequate and regular simple analgesia
- Saline nasal sprays
- Topical nasal corticosteroids
- Decongestants->do not use for longer than three days
- Topical ipratropium bromide may lessen rhinorrhea
5
Q
When to consider antibiotics
A
- Symptoms >7 days, purulent discharge, sinus tenderness, maxillary toothache
- Severe symptoms and high fever >39 at onset and lasting>3 days
- Worsening after initial improvement
6
Q
Antibiotics used
A
Amoxycillin 500mg, 15mg/kg PO 8 hourly for 5 days
If inadequate
Amoxycillin + clavulanate
7
Q
What is chronic sinusitis, contributing
A
Symptoms lasting >12 weeks Bacterial infection Allergy CF Physical obstruction Swelling for another reason Mucocillary impairment Immune deficiency Prolonged use of decongestants
8
Q
On inspection of nose, in chronic rhinosinusitis what may be found
A
Nasal polyps
9
Q
Treatment in chronic rhinosinusitis
A
Prednisilone: tapering dose over three weeks if polyps, for 5-10 days if without polyps
10
Q
Should NSAIDs be used in chronic with nasal polyps
A
Risk of sensitivity, also in asthma
11
Q
DDX of sore throat
A
- Strep pharyngitis
- Viral pharyngitis
- Infectious mononucleosis
- Tonsilitis
- Peritonsillar abscess
- Foreign body/trauma
- Leukemia
- Hodgkins disease
