Stuffy nose Flashcards
What type of hypersensitivity reaction is allergic rhinitis?
Type I, IgE mediated hypersensitivity
What happens in an IgE mediated hypersensitivity
Allergen binds to mast cells and histamine/leukotrienes are released
Pharmacological management of allergic rhinitis includes:
Topical steroids
Anti-histamines
Systemic or local decongestants
Anti-cholinergics (e.g. ipratropium) and cysLT receptor antagonists (montelukast)
The core nasal symptoms to ask about include:
Blockage
loss of smell
Discharge
Facial pain
the 4S of nasal symptoms include: 1. 2. 3. 4.
- Stuffy
- Smell
- Snot
- Sore
Sneeze, itch, crusting and epistaxis can all be symptoms of nasal problems - true/false
true
What is epistaxis
Nose bleeds
Symptoms causes by a nose problem but which are extra nasal include:
Dry mouth Sore throat Snoring Halitosis Loss of taste
Define halitosis
Bad breath
if you suspect each of the following problems, what test would you do?
- Rhintis:
- Nasal trauma:
if you suspect each of the following problems, what test would you do?
- Rhintis: Consider allergy tests
- Nasal trauma: Look at the septum e.g. for septal deviation
Infective cause of rhinitis are usually caused by ______ and are rarely ______
Viral URTIs and are rarely secondary bacterial infections
URTIs will have a lot of mucous production in the nose - true/false
True
Non-infective causes of rhinitis are split into two categories:
Allergic
Non-allergic
Give symptoms of allergic rhinitis
Sneezing Itching Running itchy eyes itchy palate
How do we treat allergic causes of rhinitis?
three pillars treatment:
Allergen avoidance
Symptomatic treatment
Immunotherapy
What do we use as symptomatic therapy for allergic rhinitis?
Topical (intranasal) steroids
nasal polyps is a cause of non-allergic rhinitis often associated with _____
Non-allergic asthma
How do we treat nasal polyps?
Short dose steroids PO
Topical steroids
Failing this course of treatment, surgery.
How is infective rhinosinusitis managed?
Endoscopically with a microdebrider to remove the polyps and pus all at once to clear the airway and sinus
What are the symptoms of rhinosinusitis
Facial pain, discharge, blockage.
What are the vast majority of rhinosinusitis caused by?§
98% viral
How are most viral rhinosinusitis usually managed?
Analgesia and decongestants
If persistent, consider ABx in case of secondary bacterial infection
What are the complications of rhinosinusitis?
Loss of vision in children
Frontal sinusitis
You should do a nasal/sinus x-ray - true/false
False - you will see NOTHING
Investigations we should do include:
Skin prick
IgE level testing
unilateral symptoms in a child should be brought to attention early because ____
this is most likely a foreign object which they may aspirate.
unilateral symptoms in adolescents/adults should be brought to attention early because ____
we need to rule out a rare malignancy of the nose.
