Stuffy nose

Question 1

What type of hypersensitivity reaction is allergic rhinitis?

Answer 1

Type I, IgE mediated hypersensitivity

Question 2

What happens in an IgE mediated hypersensitivity

Answer 2

Allergen binds to mast cells and histamine/leukotrienes are released

Question 3

Pharmacological management of allergic rhinitis includes:

Answer 3

Topical steroids
Anti-histamines
Systemic or local decongestants
Anti-cholinergics (e.g. ipratropium) and cysLT receptor antagonists (montelukast)

Question 4

The core nasal symptoms to ask about include:

Answer 4

Blockage
loss of smell
Discharge
Facial pain

Question 5

the 4S of nasal symptoms include: 
1.
2.
3.
4.

Answer 5

1. Stuffy
2. Smell
3. Snot
4. Sore

Question 6

Sneeze, itch, crusting and epistaxis can all be symptoms of nasal problems - true/false

Answer 6

true

Question 7

What is epistaxis

Answer 7

Nose bleeds

Question 8

Symptoms causes by a nose problem but which are extra nasal include:

Answer 8

Dry mouth
Sore throat
Snoring
Halitosis 
Loss of taste

Question 9

Define halitosis

Answer 9

Bad breath

Question 10

if you suspect each of the following problems, what test would you do?

• Rhintis:
• Nasal trauma:

Answer 10

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

Question 11

Infective cause of rhinitis are usually caused by ______ and are rarely ______

Answer 11

Viral URTIs and are rarely secondary bacterial infections

Question 12

URTIs will have a lot of mucous production in the nose - true/false

Answer 12

True

Question 13

Non-infective causes of rhinitis are split into two categories:

Answer 13

Allergic

Non-allergic

Question 14

Give symptoms of allergic rhinitis

Answer 14

Sneezing
Itching
Running 
itchy eyes 
itchy palate

Question 15

How do we treat allergic causes of rhinitis?

Answer 15

three pillars treatment:
Allergen avoidance
Symptomatic treatment
Immunotherapy

Question 16

What do we use as symptomatic therapy for allergic rhinitis?

Answer 16

Topical (intranasal) steroids

Question 17

nasal polyps is a cause of non-allergic rhinitis often associated with _____

Answer 17

Non-allergic asthma

Question 18

How do we treat nasal polyps?

Answer 18

Short dose steroids PO
Topical steroids
Failing this course of treatment, surgery.

Question 19

How is infective rhinosinusitis managed?

Answer 19

Endoscopically with a microdebrider to remove the polyps and pus all at once to clear the airway and sinus

Question 20

What are the symptoms of rhinosinusitis

Answer 20

Facial pain, discharge, blockage.

Question 21

What are the vast majority of rhinosinusitis caused by?§

Answer 21

98% viral

Question 22

How are most viral rhinosinusitis usually managed?

Answer 22

Analgesia and decongestants

If persistent, consider ABx in case of secondary bacterial infection

Question 23

What are the complications of rhinosinusitis?

Answer 23

Loss of vision in children

Frontal sinusitis

Question 24

You should do a nasal/sinus x-ray - true/false

Answer 24

False - you will see NOTHING

Question 25

Investigations we should do include:

Answer 25

Skin prick

IgE level testing

Question 26

unilateral symptoms in a child should be brought to attention early because ____

Answer 26

this is most likely a foreign object which they may aspirate.

Question 27

unilateral symptoms in adolescents/adults should be brought to attention early because ____

Answer 27

we need to rule out a rare malignancy of the nose.