Stuffy Noses Flashcards
What type of cells are involved in a type 1 hypersensitivity reaction
Mast cell
Histamine
Leukotrienes
What types of drugs might we prescribe for a stuffy nose
Topical corticosteroids
anti-histamines
decongestants
Anticholinergics
What are the 4 core nasal symptoms
Blockage
Loss of smell
Discharge
Facial pain
What are 4 less common nose related symptoms
sneezing
itch
crusting epistaxis
What are 5 secondary symptoms to nasal problems
dry mouth sore throat snoring halitosis loss of taste
What 3 factors are important to consider on examining a nose
Rhinoscopy
Airway patency
External nose
What are some cases of rhinitis
Infective - viral URTI
non - infective - allergic or non allergic
Describe the normal mucosa of the nose
Pink
not inflamed
no discharge
What are some symptoms of allergic conditions
Rubbing nose
Itchy palate
Itchy eyes
Allergic crease on the nose
What are 3 intermittent causes of allergic rhinitis
Grass pollen
Tree pollen (spring)
Fungal spores
What are 3 peresistent causes of allergic rhinitis
House dust mite
dog
cat
What should be prescribed if a patient has sneezing and itching
Antihistamines
What should be prescribed if the patient has nose block
topical Steroids
What should be prescribed if the patient has an itch and sneezy as well as nasal block
Topical steroids and antihistamine
Describe the appearance of bad nasal polyps on a CT scan
No air (black) areas in the sinus as they are completely blocked
What are nasal polyps often associated with
Non-allergic asthma
How do we trat nasal polyps
Oral then topical steroids
If no better then surgery
What are the 3 main features of acute infective rhino sinusitis
Facial pain
discharge
nasal blockage
How can we treat acute infective rhinosinusitis
analgesics and decongestants
if persisting / worsening - antibiotic
What can ethmoid cells infection cause
An infection affecting the orbit due to the location of the optic nerve
What happens with a pericellular orbit
Pus within the orbit - medical emergency that requires surgical drainage
High rate of blindness that could result in death
What age of patients are at risk of developing pericellular orbit
18/19 year old males or children
What is the main symptom for vasomotor rhinitis
Nasal drip in the elderly
What is the treatment for vasomotor rhinitis
Ipaitropium
What is the most common diagnosis of infective rhinitis
Rhinosinusitis
What 2 investigations should not be carried out in rhinitis
Nasal X ray or sinus X ray
What investigations should be carried out for rhinitis
Skin prick test
RAST (IgE levels)
What is the management of non-infective rhinitis
Allergen/ irritant avoidance
House dust mite
Change drug therapy (antihypertensives can cause non-infective rhinitis)
Lower alcohol intake
What can be prescribed for non-infective rhinitis
Topical nasal steroids
Antihistamine if appropriate
Topical anticholinergic - for vasomotor rhinitis
What is the management for infective rhino sinusitis
Nasal decongestant
Analgesia
? Broad spectrum antibiotic
What makes up the nasal pyramid
Upper 1/3 bony vault
Middle 1/3 cartilage vault
Lower 1/3 cartilage vault
What can happen to the nasal septum in trauma
It can be dislocated off of the floor of the nose without the nasal bones being affected
What could happen if a nasal trauma-septal haematoma was left
It could cause the cartilage of the nose to fold and become crumpled as it does not have its own blood supply
Death of cartilage
What is a rhinoplasty
Where the nasal bones need to be brought together to ultimately improve the airway
What condition can males get that females can’t in the nose
Angiofibroma
If a child presents with unilateral nasal discharge what is the most likely cause and what should you do
Foreign body
Refer urgently
If an adult presents with unilateral nasal discharge what is the most likely cause and what should you do
Paranasal tumour
Refer urgently
What is a complication of acute sinusitis
Orbital cellulitis
What should you do for a patient with a suspected orbital cellulitis
Emergency referral
Scan
Drain the puss before loss of vision occurs
