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ENT > Stuffy Nose > Flashcards

Stuffy Nose Flashcards

1
Q

what are the 2 main mediators of inflammation released by mast cells in type 1 sensitivity?

A

histamine

leukotrines

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2
Q

how does histamine cause blocked nose?

A

causes vasodilation of vessels

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3
Q

what types of drugs are used for stuffy nose?

A

topical corticosteroids
anti-histamines
decongestants
anticholinergics

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4
Q

what are the 4 core nasal symptoms?

A

blockage - stuffy
loss of smell - smell
discharge - snot
facial pain - sore

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5
Q

5 secondary symptoms of nasal problem?

A 
dry mouth
sore throat
snoring
halitosis
loss of taste
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6
Q

name 4 other nasal symptoms

A

sneezing
itching
crusting
epistaxis

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7
Q

3 components of nasal examination?

A

airway patency
external nose
rhinoscopy

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8
Q

what are the 2 groups of rhinitis and what causes each?

A 
infective = viral URTI
non-infective = allergic/non-allergic
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9
Q

what might suggest an underlying allergy in rhinitis?

A

itching (nose, eyes, soft palate)

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10
Q

what can cause intermittent allergic rhinitis?

A

grass pollen
tree pollen
fungal spores

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11
Q

what can cause persistent allergic rhinitis?

A

house dust mite
cat
dog

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12
Q

what is the aria classification?

A

classification of severity of allergic rhinitis

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13
Q

intermittent allergic rhinitis?

A

symptoms <4 days per week

or symptoms present <4 weeks

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14
Q

mild allergic rhinitis?

A

normal sleep
no impairment of daily activities, sport and leisure
normal work and school
no troublesome symptoms

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15
Q

persistent allergic rhinitis?

A

symptoms > 4 days per week
and
>4 weeks duration

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16
Q

moderate-severe allergic rhinitis?

A

abnormal sleep
impaired daily activities, sport, leisure
missing work or school
troublesome symptoms

17
Q

describe the step-wise approach to allergic rhinitis

A

allergen avoidance = best
antihistamines > topical steroids > topical steroids and antihistamines > immunotherapy for selected patients with IgE mediated disease > surgery for specific indications for relief of obstruction

18
Q

causes of nasal obstruction?

A

mucosal hypertrophy

nasal polyps

19
Q

what are nasal polyps associated with and how are they managed?

A

associated with non-allergic asthma

treatment = topical steroids, surgery if no better

20
Q

how can you tell the difference between nasal poly and inferior turbinate?

A

polyp does not have sensation so can be touched and moved without being uncomfortable

21
Q

what are 3 features of acute infective rhinosinusitis?

A

facial pain
discharge
nasal blockage/loss of smell

22
Q

what normally causes acute infective sinusitis and how is it managed?

A

98% are viral
most are self limiting with analgesia and decongestants
only add antibiotic if persisting/worsening after a while

23
Q

what is the danger in orbital cellulitis?

A

infection can spread to cavernous sinus which can cause thrombosis

24
Q

how is rhinitis investigated if though to be allergic?

A

skin prick test

RAST (IgE)

25
Q

what methods of investigations are not used in rhinitis?

A

nasal and sinus X rays

26
Q

how is non-infective rhinitis managed non-pharmacologically?

A

allergen/irritant avoidance
HDM (house dust mites) specific IgE
change drug therapy
reduce alcohol etc

27
Q

how is non-infective rhinitis managed pharmacologically?

A

topical nasal steroid +/- antihistamine

topical anticholinergic

28
Q

how is infective rhinosinusitis managed?

A

nasal decongestant
analgesia
broad spectrum antibiotic if needed

29
Q

how is nasal trauma managed?

A

assess breathing and any immediate problems
leave alone and reassess in 1 week
then surgery if needed (should be performed in <3 weeks)

30
Q

how is nasal septal haematoma managed?

A

drain it out and suture perichondrium back together

31
Q

how is a child with unilateral discharge managed?

A

refer urgently

possible foreign body in the nose

32
Q

how is an adult with unilateral discharge managed?

A

refer urgently

possible nasal or paranasal tumour

33
Q

orbital cellulitis can result as a complication of what?

A

acute sinusitis

34
Q

what might ipratropium be used for?

A

to dry up a very runny nose

ENT (21 decks)

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