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ENT Medicine > The Stuffy Nose > Flashcards

The Stuffy Nose Flashcards

1
Q

What immune process is a stuffy nose associated with?

A

IgE mediated type 1 hypersensitivity

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2
Q

What do mast cells release that promote a stuffy nose?

A

Histamine and leukotrienes

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3
Q

What are some drugs used to treat rhinitis?

A

Topical corticosteroids (beclomethasone)
Anti-histamines (cetirizine)
Anticholinergics (ipratropium)
Decongestants (pseudoephedrine)

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4
Q

What are the core nasal symptoms of rhinitis?

A

Blockage, loss of smell, discharge, facial pain (stuffy, smell, snot, sore)

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5
Q

What are some other nasal symptoms that may accompany rhinitis?

A

Sneezing, itch, crusting, epistaxis

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6
Q

What are some secondary symptoms to rhinitis?

A

Dry mouth, sore throat, snoring, halitosis, loss of taste

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7
Q

How may a nose be examined?

A

Airway patency, external nose, may use rhinoscopy

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8
Q

What are the types of rhinitis?

A

Infective (viral URTI) or non-infective

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9
Q

What is non-infective rhinitis divided into?

A

Allergic and non-allergic

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10
Q

What are some triggers that may cause intermittent allergic rhinitis?

A

Grass or tree pollen, fungal spores

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11
Q

What are some allergens that may cause persistent allergic rhinitis?

A

House dust mite, cat or dog

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12
Q

What is the ARIA classification for intermittent allergic rhinitis?

A

Symptoms <4 days per week of symptoms for <4 weeks

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13
Q

What is the ARIA classification for persistent allergic rhinitis?

A

Symptoms >4 days per week and >4 weeks duration

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14
Q

What is the ARIA classification for mild allergic rhinitis?

A

Normal sleep, no impairment of daily activities, normal work/school, no troublesome symptoms

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15
Q

What is the ARIA classification for moderate/severe allergic rhinitis?

A

One or more = abnormal sleep, troublesome symptoms, impairment of daily activities, missing work/school

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16
Q

What is the treatment pyramid for allergic rhinitis?

A

Step 1 = avoidance of allergen
Step 2 = antihistamines
Step 3 = topical steroids
Step 4 = topical steroids and antihistamines

17
Q

When is immunotherapy given for allergic rhinitis?

A

For selected patients with IgE mediated disease

18
Q

What are nasal polyps often associated with?

A

Non-allergic asthma

19
Q

How are nasal polyps treated?

A

Oral then topical steroids, surgery if no improvement

20
Q

How does acute infective rhinosinusitis present?

A

Facial pain, discharge, nasal blockage

21
Q

What causes most cases of acute infective rhinosinusitis?

A

98% of cases are viral

22
Q

How is acute infective rhinosinusitis treated?

A

Analgesics and decongestants, if worsening or persisting then add antibiotics

23
Q

What are some causes of non-allergic rhinitis?

A

Nasal polyps, vasomotor rhinitis

24
Q

What investigations are not recommended for rhinitis?

A

Nasal or sinus x-rays

25
Q

What are some management options for non-infective rhinitis?

A

Allergen/irritant avoidance, HDM, change drug therapy, topical nasal steroid +/- antihistamine, topical anticholinergic

26
Q

What are some treatment options for infective rhinitis?

A

Nasal decongestant, analgesia, broad spectrum antibiotic

27
Q

What are some examples of nasal trauma injuries?

A

Septal haematoma, fracture, cartilage dislocation

28
Q

How should unilateral nasal discharge be handled?

A

Urgent referral

29
Q

What may be a cause of unilateral nasal discharge in an adult?

A

Nasal or paranasal tumour

30
Q

What may cause unilateral nasal discharge in an infant?

A

Foreign body in nose

31
Q

What may orbital cellulitis occur as a result of?

A

Complication of acute sinusitis

32
Q

How does orbital cellulitis present?

A

Unilateral eye swelling = needs urgent referral

ENT Medicine (22 decks)

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