Stuffy Nose

Question 1

What is the effect of the sympathetic nervous system on the nose?

Answer 1

Opens and dries

Question 2

What is the effect of the parasympathetic nervous system on the nose?

Answer 2

Closes and causes a runny nose

Question 3

Name some core symptoms of a stuffy nose

Answer 3

• blockage
• loss of smell
• discharge
• facial pain
• sneezing
• itch
• crusting
• epistaxis
• dry mouth/loss of taste
• sore throat
• snoring
• halitosis

Question 4

What is a red flag in any nasal problem?

Answer 4

unilateral symptoms

Question 5

What are the two main types of rhino sinusitis?

Answer 5

Infective and non-infective

Question 6

What is infective rhino sinusitis usually caused by?

Answer 6

Viral Upper Respiratory Tract Infection

Question 7

Name two types of non-infective rhino sinusitis?

Answer 7

Allergic and non-allergic

Question 8

Name the two types of allergic rhinitis

Answer 8

Intermittent (grass/tree pollen or fungal spores)

Persistent (house dust mites, cats, dogs)

Question 9

What tests can be used to help identify a trigger in allergic rhinitis?

Answer 9

IgE RAST test or skin prick test

Question 10

How is allergic rhinitis treated?

Answer 10

• Allergen avoidance
• Immunotherapy
• Symptomatic Therapy

Question 11

What does symptomatic therapy of rhinitis involve?

Answer 11

• antihistamines
• topical steroids
• surgery for mucosal hypertrophy

Question 12

Name a disease associated with nasal polyps

Answer 12

Non-allergic asthma

Question 13

In addition to polps what other sign may been seen

Answer 13

Telangiectasia

Question 14

How are nasal polyps treated?

Answer 14

Oral then topical steroids

If unsuccessful surgery is required

Question 15

A viral URTI can lead to what?

Answer 15

Secondary bacterial infection

Question 16

How does infective rhino sinusitis present?

Answer 16

Facial pain, discharge, nasal blockage

Question 17

How can infective rhino sinusitis be treated?

Answer 17

Analgesia and decongestants but if persistent antibiotics may be required

Question 18

Name the complications of rhino sinusitis

Answer 18

• orbital cellulitis and abscess
• brain abscess
• osteomyelitis
• meningitis
• cavernous sinus thrombosis (follows ethmoid infection)
• cutaneous fistula

Question 19

How are the complications of rhino-sinusitis usually managed?

Answer 19

CT followed by surgical drainage and antibiotics

Question 20

What is vasomotor rhinitis?

Answer 20

Blood vessels within the nose dilate leading to swelling and congestion - often in older patients who present with a runny nose

Question 21

Describe the bone-cartilage ratio of the nose

Answer 21

Upper third - bone

Lower two thirds - cartilage

Question 22

What is a septal haematoma?

Answer 22

Blood supply from the perichondrium leaks which can lead to necrosis of the cartilage

Question 23

Name four other causes of a stuffy nose

Answer 23

• adenoids (ear and sleep problems)
• foreign body (smelly discharge)
• mucocele (mucus cyst, can cause infection)
• sinus tumour

Question 24

How does a sinus tumour usually present?

Answer 24

Late with a puffy face and numb feeling with unilateral discharge