The Stuffy Nose

Question 1

the common stuffy nose is what type of hypersensitivity reaction?

Answer 1

type I IgE mediated hypersensitivity reaction

Question 2

what do mast cells release?

Answer 2

histamine and leukotrienes

Question 3

name a topical corticosteroid used in the stuffy nose

Answer 3

beclomethasone

Question 4

name an anti-histamine used in the stuffy nose

Answer 4

cetirizine

Question 5

name a decongestant used in the stuffy nose

Answer 5

pseudoephedrine

Question 6

name an anticholinergic used in the stuffy nose

Answer 6

ipratropium

Question 7

name the 4 core nasal symptoms in the stuffy nose

Answer 7

S rule:

Stuffy - blockage
Smell - loss of smell
Snot - discharge
Sore - facial pain

Question 8

name the 2 types of rhinitis

Answer 8

infective and non-infective

Question 9

what is the cause of an infective rhinitis

Answer 9

viral URTI

Question 10

name the 2 types of non-infective rhinitis

Answer 10

allergic or non-allergic

Question 11

name some intermittent triggers of allergic rhinitis

Answer 11

grass pollen
tree pollen
fungal spores

Question 12

name some persistent triggers of allergic rhinitis

Answer 12

house dust mite
cat
dog

Question 13

intermittent or persistent allergic rhinitis:

symptoms <4 days per week OR symptoms for <4 weeks

Answer 13

intermittent

persistent is AND instead of OR

Question 14

moderate-severe allergic rhinitis must include what?

Answer 14

one or more of:

abnormal sleep
impairment of sport or leisure
missing work
troublesome symptoms

Question 15

outline the 5 steps in the ladder to allergic rhinitis

Answer 15

allergen avoidance

antihistamines

topical steroids

topical steroids + antihistamines

(immunotherapy or surgery)

Question 16

associated with non-allergic asthma

treatment is oral then topical steroids

surgery if no better

diagnosis?

Answer 16

nasal polyps

Question 17

facial pain
discharge
nasal blockage

diagnosis?

Answer 17

acute infective rhinosinusitis

Question 18

acute infective rhinosinusitis is usually what in nature?

Answer 18

viral

Question 19

acute infective rhinosinusitis treatment?

Answer 19

analgesics and decongestants

add antibiotic if no better

Question 20

investigations into allergic rhinitis?

Answer 20

skin prick test

RAST (IgE level)

Question 21

name the common implication of nasal trauma

Answer 21

septal haematoma

Question 22

sinus ________ and sinus _______ can also cause stuffy noses

Answer 22

sinus BLOCKAGE and sinus TUMOURS can also cause stuffy noses

Question 23

unilateral discharge in child

diagnosis?

Answer 23

foreign body

Question 24

unilateral discharge in adult

diagnosis?

Answer 24

nasal or paranasal tumour

Question 25

foreign body or nasal/paranasal tumour refer urgently?

Answer 25

yes

Question 26

name a complication of acute sinusitis that requires emergency referral

Answer 26

orbital cellulitis

Question 27

non-infective rhinitis drug treatment?

Answer 27

topical nasal steroid
antihistamine
topical anticholinergic

Question 28

infective rhinitis drug treatment?

Answer 28

nasal decongestant
analgesia
broad spectrum antibiotic

Question 29

what is the upper 1/3 of nose composed of?

Answer 29

bone

Question 30

what is lower 2/3 of nose composed of?

Answer 30

cartilage