The nose Flashcards
What 3 arteries make up Kiesselbach’s area?
Anterior ethmoidal
Posterior ethmoidal
Sphenopalatine.
What genetic syndrome is the inability to smell with low GnRH
Kallman’s
Allergic rhinosinusitis mediated by what antibody?
IgE
Management of rhinosinusitis?
1) Inhaled/steroids. (Avamys). Contains fluticasone.
2) Decongestants (pseudoephedrine). Only use short term tho as can cause rebound congestion and necrosis of the septum.
Management of allergic rhinosinusitis?
1) antihistamines.
2) Steroids.
3) antihistamines + steroids.
Rhinosinusitis presents with 2 of the following?
Nasal congestion Nasal discharge Nasal crusting Facial pain or fullness Reduced sense of smell Sneezing, itch, fever,
Nasal discharge can be ant or post with posterior being post nasal drip which causes bad tase.
Typically, facial pain is worse on leaning forward.
Infective sinusitis?
Can occur 2* to viral infection or after surgery.
Management of infective sinusitis?
Most will resolve within 2 weeks.
ABx should only be used if worsening symptoms after7 10 days.
What ABx for infective sinusitis if not cleared up after 7 -10days?
1) Penicllin V
2) Doxycyline.
Alarm symptom for nasal polyps?
Nasal polyps should always be BILATEAL = unilateral is worrying
If a child less that 10 present with nasal polyps what should u consider?
Cystic fibrosis or malignancy.
Presentation of nasal polyps?
Bilateral nasal congestion. Watery anterior rhinorrhoea. Purulent post nasal drip,. Taste disturbance Mouth breather and snoring
Typically a woman in her 40s.m
1st and 2nd line Rx of nasal polyps?
1) topical steroid +/- montelukast
2) Endoscopic polypectomy
treatment algorith for nose bleed?
1) Cautery
2) Anterior nasal pack
3) Posterior nasal pack
4) Endoscopic ligation of sphenopalatine artery
5) Ligation of external carotid
6) Embolisation.
How long do anterior nasal packs stay in for?
24 hours
How long do posterior nasal packs stay in for?
48 hours.
What is choanal atresia?
Congenital abnormality in which there is blockage of the posterior nasal cavity. If it is bilateral then it usually presents with difficulty breathing following birth.
CSF rhinorrhoea (2 signs)
Assoc with trauma but also tumours.
Positive glucose
What protein positive in CSF rhinorrhoea?
Positive B2 Tau protein.
Nystagmus is observed in what type of pathology?
In vestibular pathologies.
How do you differentiate BPPV from verterobasillar insufficiency?
Vertebrobasillar insufficiency has visual disturbance weakness and numbness too (impaired posterior circulation)
What exercises can you teach a. Patient to do who has BPPV?
Brandt Daron exercises.
What antibiotic can be Helpful for Menieres?
Intratympanic gentamicin.
