Stuffy Nose Flashcards
What are the 4 core nasal problems?
- Blocked nose
- Loss of smell
- Discharge
- Facial pain
(4Ss - stuffy, smell, snot, sore)
What are the two types of rhinitis?
- Non-infective - Allergic
- Infective - viral URTI
What typically causes infective rhinitis?
Viral URTI
What are the two type of non-infective rhinitis?
- Allergic
- Non-allergic
Allergic rhinitis can be either _______ or _________
Allergic rhinitis can be either intermittent or persistent
Which allergens can induce intermittent rhinitis?
- Grass pollen
- Tree pollen
- Fungal spores (e.g. cladosporidum)
Which allergens can induce persistent rhinitis?
- House dust mites
- Cat
- Dog
(salivary enzymes from cats and dogs cause allergic rhinits)
How can intermittent allergic rhinitis be classified?
Symptoms for <4 days per week
or
Symptoms for <4 weeks
How can persistent allergic rhinitis be classified?
Symptoms >4 days week
and
>4 weeks duration
What treatment options are there for allergic rhinitis?
- Allergen avoidance
- Symptomatic relief (antihistamines, topical steroids)
- Immunotherapy
- Surgery
Nasal polyps are often associated with which other condition?
Non-allergic asthma
How can nasal polyps be treated?
Oral then topical steroids
Surgery (if failure to improve)
Which key symptoms are associated with acute infective rhinosinusitis?
- Facial pain
- Discharge
- Nasal blockage
How should acute infective rhinosinusitis be treated?
Analgesics
Decongestants
Antibiotic (if persistent)
Infective rhinosinusitis is almost entirely caused by what?
Viruses (98%)
What are the two main types of non-allergic rhinitis?
- Vasomotor rhinitis
- Nasla polyps
How can non-infective rhinitis be treated?
- Topical nasal steroid
- Antihistamine (if required)
- Topical anticholinergic
Why do most nasal fractures deviate to the left?
Mostly caused by fights
Most people (90%) are right handed
What is a septal haematoma?
Blood underneath the perichonrium in the nasal cartilage
This prevents cartilage getting nutrients and O2 leading to death and nasal collapse
What is the number one cause of unilateral discharge in
a) Young children
b) Adults
a) Young children - Foreign body in the nose
b) Adults - Paranasal tumour
What is a severe complication of acute sinusitis?
Orbital cellulitis
How can specific allergens be tested for in allergic rhinitis?
Skin prick test
Radioallergosorbent assay (RAST) - detects specific IgE
Was was the initial reason for IgE to exist?
To try and get rid of worms
What are the symptoms of acute infective rhinosinusitis?
what is the most common cause?
facial pain
discharge
nasal blockage
viral 98%
describe the anatomy of the nose (bone and cartilage)
upper 1/3 is bone
the rest is cartilage
What are the complications of bacterial rhinosinutitis?
orbital abcess, cavernous sinus thrombosis and meningitis
When should a nasal fracture be assessed to check if local manipulation is needed?
7-14 days after the event
What is stridor?
High pitched inspiratory wheeze
What is the cause of respiratory papilomatous disease?
HPV
What is a definitive airway?
tracheal intubation or tracheostomy
WHat are the steps of the reconstructive ladder?
healing by secondary intention
priamry closure
skin grafts
skin flaps
