Stuffy Nose

Question 1

What are the main core nasal symptoms?

Answer 1

Blockage
Loss of smell
Discharge/epistaxis
sneezing/itch
crusting

Question 2

What other non-nasal symptoms are related to nasal pathology?

Answer 2

dry mouth
sore throat
snoring
halitosis
loss of taste

Question 3

How can airway patency be determined during examination?

Answer 3

Placing finger beneath nostril and asking patients to breath in => allows you to feel force of inhalation

Place cold rod under nostrils and examine water vapour produced when they breath

Question 4

What usually causes an infective rhinitis?

Answer 4

Viral upper respiratory tract infection

Question 5

What are the two types of non-infective rhinitus?

Answer 5

Allergic

Non-allergic

Question 6

Excess mucous on nasal endoscopy indicates an abnormality. TRUE/FALSE?

Answer 6

TRUE

Question 7

What different substances cause intermittent allergy at specific times of the year?

Answer 7

tree pollen = spring
grass pollen = summer
fungal spores = autumn/winter

Question 8

What are the usual causes for persistent allergic rhinitis?

Answer 8

House dust mite
Cat
Dog

Question 9

How long do patients need to experience symptoms for allergic rhinitis to be classified as persistent?

Answer 9

Symptoms > 4 days per week

and > 4 weeks duration

Question 10

What symptoms would indicate moderate to severe persistent allergic rhinitis?

Answer 10

abnormal sleep
impairment of daily activities
missing work or school

Question 11

Describe the stepwise approach to allergic rhinitis

Answer 11

Allergen Avoidance
Antihistamines
Topical Steroids
Antihistamines+Topical Steroids

Question 12

What condition are nasal polyps associated with?

Answer 12

Non-allergic asthma

Question 13

How are nasal polyps treated?

Answer 13

Oral then topical steroids

If no improvement = surgery

Question 14

What are the 3 main symptoms in infective rhinosinusitis?

Answer 14

Facial pain
Discharge
Nasal blockage

Question 15

Most infective rhinosinusitis is due to a viral cause. TRUE/FALSE?

Answer 15

TRUE

98%

Question 16

How is infective rhinosinusitis treated?

Answer 16

• analgesics and decongestants

- persisting/ worsening = add antibiotic

Question 17

What are the complications of infective rhinosinusitis?

Answer 17

Orbital cellulitis

Thromboembolus formation in the cavernous sinus

Question 18

What is vasomotor rhinitis?

Answer 18

Parasympathetic problem
Presents in old people
“Drippy nose”

Question 19

Nasal and sinus X-Rays are important investigations during diagnosis. TRUE/FALSE?

Answer 19

FALSE

not required

Question 20

How can trauma to the nose cause “stuffiness”?

Answer 20

Cartilage falls back on itself
bone fractures
septal haematomas form and can kill cartilage

Question 21

What must you always remember to look for in children with a stuffy nose?

Answer 21

Foreign body

Question 22

Paranasal tumours can cause sensation of a blocked nose. TRUE/FALSE?

Answer 22

TRUE