"Stuffy Nose" Flashcards
What type of hypersensivity reaction is occuring in allergic rhinits?
Type 1
Name the 4 core nasal symptoms (related to rhinitis)
Blockage
Loss of sense of smell
Nasal discharge
Facial pain
Other smptoms include: Sneezing Itching Crusting in nose Epitaxis
Definition of rhinitis:
Inflammation of the mucous membrane of the nose
List (8) nasal symtoms (often reated to rhinitis):
Blockage Anosmia Nasal dischange Facial Pain Sneezing Itching (crusting in nose) Epitaxis
Name (5) secondary symptoms to a blocked nose?
Dry mouth Sore throat Halitosis Snoring Loss of sense of taste (possibly partly due to anosmia, possibly partly due to dry mouth, caused by mouth-breathing)
What (3) things are you aiming to establish in a nasal examination?
Are the airways patent?
Is there any deviation of external nose?
What is the mucosa like inside the nose?
What is the tool called that shines a light into the patient’s nose to look at the mucosa?
Oroscope
What is the most common infective cause of rhinitis?
Virus
What does healthy mucosa inside the nose look like?
Pink, not inflamed, no thick mucous
What is vasomotor rhinitis?
Nonallergic rhinitis (vasomotor rhinitis) is a condition that causes chronic sneezing, congestion, or runny nose. While these symptoms are similar to those of allergic rhinitis (hay fever), nonallergic rhinitis is different because, unlike an allergy, it doesn’t involve the immune system.
Name (3) causes of persistant allergic rhinits:
Cats (enzyme in cat saliva)
House dust mite (and house dust mite faeces)
Dogs
Why are cats particularly allergenic?
Enzme in cat saliva is an allergen
Cats lick self
What is the classification for “persistent” allergic rhinitis?
> 4 days/week
AND
1 months/year
What is the classification for “intermittent” allergic rhnitis?
<4 days a week
OR
<1 month a year
What is the description of “mild” allergic rhinitis?
Normal sleep
No impairment of daily activitis, sports, leisure
No missing work/school
No troublesome symptoms
What is the description for “moderate-severe” allergic rhinitis?
Abnormal sleep
Impairment of daily activities, sports, leisure
Missing work/school
Troublesome symptoms
What is the stepwise approach to treatment of allergic rhinits?
(Allergen avoidance)
- Antihistamines
- Topical steroids (good if blockage)
- Antihistamines + Topical steroids
Treatment for nasal polyps:
- Oral steroids
- Topical steroids
IF NO BETTER –> Surgery
Name (3) symptoms of acute infective rhinitis:
Facial pain
Discharge
Nasal blockage
Treatment for acute infective rhinitis:
Analgaesics
Decongestants
(IF persisting/worsening) –> Add antibiotic (broad spectrum)
Investigations for rhinitis:
2
Skin prick test
RAST (IgE levels)
(Do NOT do nasal x-ray or sinus x-ray!!)
Management of non-infective rhinitis:
(allergen/irritant avoidance)
- Topical nasal steroid
- (+/- antihistamine)
- Topical anticholinergic
Management of infective rhinitis:
Nasal decongestant (short-term use) Analgesia (if pain)
–> MAY have to add broad spectrum anti-biotic
What is rhinoplasty?
Plastic surgery performed on the nose
Why is unilateral discharge worrying in children?
? foreign body in nose
REFER URGENTLY
Why is unilateral discharge worrying in adults?
? nasal or paranasal tumour
REFER URGENTLY
Name a complication of acute sinusitis that needs emergency referal:
Orbital cellulitis
