Stuffy Nose

Question 1

What are the 4 core nasal problems?

Answer 1

1. Blocked nose
2. Loss of smell
3. Discharge
4. Facial pain

(4Ss - stuffy, smell, snot, sore)

Question 2

What are the two types of rhinitis?

Answer 2

1. Non-infective - Allergic
2. Infective - viral URTI

Question 3

What typically causes infective rhinitis?

Answer 3

Viral URTI

Question 4

What are the two type of non-infective rhinitis?

Answer 4

1. Allergic
2. Non-allergic

Question 5

Allergic rhinitis can be either _______ or _________

Answer 5

Allergic rhinitis can be either intermittent or persistent

Question 6

Which allergens can induce intermittent rhinitis?

Answer 6

1. Grass pollen
2. Tree pollen
3. Fungal spores (e.g. cladosporidum)

Question 7

Which allergens can induce persistent rhinitis?

Answer 7

1. House dust mites
2. Cat
3. Dog

(salivary enzymes from cats and dogs cause allergic rhinits)

Question 8

How can intermittent allergic rhinitis be classified?

Answer 8

Symptoms for <4 days per week

or

Symptoms for <4 weeks

Question 9

How can persistent allergic rhinitis be classified?

Answer 9

Symptoms >4 days week

and

>4 weeks duration

Question 10

What treatment options are there for allergic rhinitis?

Answer 10

1. Allergen avoidance
2. Symptomatic relief (antihistamines, topical steroids)
3. Immunotherapy
4. Surgery

Question 11

Nasal polyps are often associated with which other condition?

Answer 11

Non-allergic asthma

Question 12

How can nasal polyps be treated?

Answer 12

Oral then topical steroids

Surgery (if failure to improve)

Question 13

Which key symptoms are associated with acute infective rhinosinusitis?

Answer 13

1. Facial pain
2. Discharge
3. Nasal blockage

Question 14

How should acute infective rhinosinusitis be treated?

Answer 14

Analgesics

Decongestants

Antibiotic (if persistent)

Question 15

Infective rhinosinusitis is almost entirely caused by what?

Answer 15

Viruses (98%)

Question 16

What are the two main types of non-allergic rhinitis?

Answer 16

1. Vasomotor rhinitis
2. Nasla polyps

Question 17

How can non-infective rhinitis be treated?

Answer 17

1. Topical nasal steroid
2. Antihistamine (if required)
3. Topical anticholinergic

Question 18

Why do most nasal fractures deviate to the left?

Answer 18

Mostly caused by fights

Most people (90%) are right handed

Question 19

What is a septal haematoma?

Answer 19

Blood underneath the perichonrium in the nasal cartilage

This prevents cartilage getting nutrients and O2 leading to death and nasal collapse

Question 20

What is the number one cause of unilateral discharge in

a) Young children
b) Adults

Answer 20

a) Young children - Foreign body in the nose
b) Adults - Paranasal tumour

Question 21

What is a severe complication of acute sinusitis?

Answer 21

Orbital cellulitis

Question 22

How can specific allergens be tested for in allergic rhinitis?

Answer 22

Skin prick test

Radioallergosorbent assay (RAST) - detects specific IgE

Question 23

Was was the initial reason for IgE to exist?

Answer 23

To try and get rid of worms

Question 24

What are the symptoms of acute infective rhinosinusitis?

what is the most common cause?

Answer 24

facial pain

discharge

nasal blockage

viral 98%

Question 25

describe the anatomy of the nose (bone and cartilage)

Answer 25

upper 1/3 is bone

the rest is cartilage

Question 26

What are the complications of bacterial rhinosinutitis?

Answer 26

orbital abcess, cavernous sinus thrombosis and meningitis

Question 27

When should a nasal fracture be assessed to check if local manipulation is needed?

Answer 27

7-14 days after the event

Question 28

What is stridor?

Answer 28

High pitched inspiratory wheeze

Question 29

What is the cause of respiratory papilomatous disease?

Answer 29

HPV

Question 30

What is a definitive airway?

Answer 30

tracheal intubation or tracheostomy

Question 31

WHat are the steps of the reconstructive ladder?

Answer 31

healing by secondary intention

priamry closure

skin grafts

skin flaps