The stuffy nose

Question 1

what are the core nasal symptoms?

Answer 1

blockage 
loss of smell 
discharge 
facial pain 
sneezing 
itch 
crusting
epistaxis

Question 2

what are secondary nasal symptoms?

Answer 2

dry mouth 
sore throat 
snoring 
halitosis 
loss of taste

Question 3

what do you look for in nasal examination?

Answer 3

airway latency
external nose
rhinoscopy

Question 4

how to check airway patency?

Answer 4

close one nose and ask to breathe through the other nose

Question 5

what are the investigations for stuffy nose?

Answer 5

depend on the underlying cause - rhinitis, sinusitis, nasal trauma, unilateral symptoms

Question 6

what is rhinitis?

Answer 6

inflammation of the nose

Question 7

what are the two types of rhinitis?

Answer 7

infective and non infective

Question 8

non infective rhinitis is further divided into?

Answer 8

allergic and non-allergic

Question 9

what is a cause of infective rhinitis?

Answer 9

viral URTI

Question 10

what is the two types of allergic rhinitis?

Answer 10

intermittent and persistent

Question 11

what are the causes of intermittent allergic rhinitis?

Answer 11

grass pollen, tree pollen, fungal spores

Question 12

what is intermittent allergic rhinitis?

Answer 12

there is a period where the allergy stops

Question 13

what are the causes of persistent allergic rhinitis?

Answer 13

house dust mite
cat
dog

Question 14

what is the classification for rhinitis?

Answer 14

ARIA classification:
divided into intermittent 
persistent 
mild 
moderate- severe

used in untreated patents

Question 15

aria intermittent classification:

Answer 15

Symptoms <4 days per week

. or symptoms for <4 weeks

Question 16

aria persistent classification?

Answer 16

Symptoms > 4 days per week

. and > 4 weeks duration

Question 17

mild aria classification?

Answer 17

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

Question 18

moderate - severe aria classification?

Answer 18

one or more items
. 	abnormal sleep
. 	impairment of daily activities, sport, leisure
. 	missing work or school
. 	troublesome symptoms

Question 19

nasal polyps:

Answer 19

often associated with non-allergic asthma

treat with oral then topical steroids - if full of polyps might be difficult to get topical steroids in

if no better -> surgery

polyps have no sensation

Question 20

presentation acute infection rhinosinusitis:

Answer 20

facial pain
discharge
nasal blockage
reduced sense of smell

Question 21

cause of acute infective rhino sinusitis?

Answer 21

98% are viral and will get better by themselves

Question 22

treatment for acute infective rhino sinusitis?

Answer 22

treat with analgesics and decongestants

if persisting/worsening add antibiotic

Question 23

presentation of nasal trauma?

Answer 23

unilateral blockage
cartilage or bones can be fractured
depends on the force and location of trauma