The Stuffy Nose Flashcards
the common stuffy nose is what type of hypersensitivity reaction?
type I IgE mediated hypersensitivity reaction
what do mast cells release?
histamine and leukotrienes
name a topical corticosteroid used in the stuffy nose
beclomethasone
name an anti-histamine used in the stuffy nose
cetirizine
name a decongestant used in the stuffy nose
pseudoephedrine
name an anticholinergic used in the stuffy nose
ipratropium
name the 4 core nasal symptoms in the stuffy nose
S rule:
Stuffy - blockage
Smell - loss of smell
Snot - discharge
Sore - facial pain
name the 2 types of rhinitis
infective and non-infective
what is the cause of an infective rhinitis
viral URTI
name the 2 types of non-infective rhinitis
allergic or non-allergic
name some intermittent triggers of allergic rhinitis
grass pollen
tree pollen
fungal spores
name some persistent triggers of allergic rhinitis
house dust mite
cat
dog
intermittent or persistent allergic rhinitis:
symptoms <4 days per week OR symptoms for <4 weeks
intermittent
persistent is AND instead of OR
moderate-severe allergic rhinitis must include what?
one or more of:
abnormal sleep
impairment of sport or leisure
missing work
troublesome symptoms
outline the 5 steps in the ladder to allergic rhinitis
allergen avoidance
antihistamines
topical steroids
topical steroids + antihistamines
(immunotherapy or surgery)
associated with non-allergic asthma
treatment is oral then topical steroids
surgery if no better
diagnosis?
nasal polyps
facial pain
discharge
nasal blockage
diagnosis?
acute infective rhinosinusitis
acute infective rhinosinusitis is usually what in nature?
viral
acute infective rhinosinusitis treatment?
analgesics and decongestants
add antibiotic if no better
investigations into allergic rhinitis?
skin prick test
RAST (IgE level)
name the common implication of nasal trauma
septal haematoma
sinus ________ and sinus _______ can also cause stuffy noses
sinus BLOCKAGE and sinus TUMOURS can also cause stuffy noses
unilateral discharge in child
diagnosis?
foreign body
unilateral discharge in adult
diagnosis?
nasal or paranasal tumour
foreign body or nasal/paranasal tumour refer urgently?
yes
name a complication of acute sinusitis that requires emergency referral
orbital cellulitis
non-infective rhinitis drug treatment?
topical nasal steroid
antihistamine
topical anticholinergic
infective rhinitis drug treatment?
nasal decongestant
analgesia
broad spectrum antibiotic
what is the upper 1/3 of nose composed of?
bone
what is lower 2/3 of nose composed of?
cartilage
