Upper Airway Disorders

Question 1

Sinusitis

Answer 1

Affects paranqsal sinuses
Sometimes following viral upper resp tract infection, 
Bact: streptococcus pneumoniae
Frontal headache
Facial pain
Nasal stiffness
Discharge

Broad spectrum antibiotics
Chronic sinusitis-> facial fullness

Question 2

What is an Uncommon complication of sinusistis?

Answer 2

Cerebral abscess

Question 3

Nasal polyps symptoms??

Answer 3

Smooth pale, shiny polypoid structrures
Arise from nasal or sinus mucosa( usually ethmoid)
Asprin sensitivity, asthma & nasal polyps often coesxist.
Ansomnia
Postnasal drip
Blocked nose-> mouth breathe.

Question 4

How do you trat nasal polyps?

Answer 4

Decongestants and nasal steroids,
Sometimes/ endoscopic sinus surgery
Reoccur after surgery

Question 5

What is rhinitis? What are the common symptoms?

Answer 5

Inflmamatory conditon, Xs mucuc production,

Intermidently blocked + runny nose, itchy nose, sniffing, impaired sense of smell.

Question 6

What causes rhinitis?

Answer 6

Allergens eg house dust mites, grass, tree pollens, animal danders.
Can be associated with conjuctivitis & wheezing.
May have asthma.

Question 7

What is the diagnostic tool for rhinitis?

Answer 7

Radioallergoabsorbant testing (RAST) detect specific IgE levels to diff allergens.

Question 8

Is Rhinitis caused only be allergens?

Answer 8

Non-allergic rhinitis-> vasomotor rhinitis or occur as a consequence of exercise, cold weather or food intolerance.

Question 9

What is coryza? And what are the symptoms?

Answer 9

The common cold, 
Highly infectious, characterised my mild systemic upset, (fever, malaise, anorexia), sore throat, sneezing, a runny nose.
Rhinovirus
Parainfluenza virus
Adenovirus

Question 10

What are the symptoms of severe rhinitis?

Answer 10

Systemic upset, dirficulty in sleeping

Question 11

What is the treatment of rhinitis?

Answer 11

Allergen avoidance
Topical steroids
Antihistamines

Question 12

Reasons for referral in patients with chronic (>8 weeks) cough:

Answer 12

Wt loss
Haemoptosis
Purulent sputum
Night sweats
RFs for immunosupression
Difficult symptom control

Question 13

Tonsilitis- symptoms & cause

Answer 13

Viruses, bacteria,

Fever, malaise, sore throat, odynophagia (pain on swolling)

Question 14

If mild cervical lymphadenopathy ❌❌?

Answer 14

Infectious mononucleosis (granular fever) 
↪️ monospot test to detect heterophile antibody.

Question 15

What is the peritonsilar abscess?what happens?

Answer 15

Complication of to tonsilitis
Quinsy- unilateral sore throat, diff swallong,
Nasal voice
Diff opening mouth (masseteric muscle spam- trismus)

Question 16

What is the Treatment of tonsilitis?

Answer 16

Uncomplicated-
Oral penicillin V
Aspiration of pus if quinsy present.

Question 17

What is epiglittitis? What causes it? What are the symptoms?

Answer 17

❌❌ potentially life threatening
Caused by H. Influenza type B
Produces airway obstruction,
Less common in >5 years,
Fevere, drooling, odynophagia diff breathing.
Usually systemiaclly unwell.
Epiglottis: red& swollen, visualised only when airaway assistance available.

Question 18

What is the treatment of epiglottitis?

Answer 18

Broad-spectrum antibiotics

3rd generation cephalosporin.

Question 19

What happens in foreign body inhalation? Most common in_____?

Answer 19

Children!

Adults; tooth, penaut. Usually, lodged in right main bronchus.

Question 20

Why do foregn bodies get lodged in the right main bronchus more commonly?

Answer 20

Less acute; more verical, wider.

Question 21

How do we force the foreign body out?

Hemilich manoeuvre .

Answer 21

Encircle arms around upper part of abdomen, below ribcage,
Give sharp squeeze, forcing diaphragm into thorax sharply.
In order to expel sufficient air from lungs to force the foreign body out of the trachea.

Question 22

What are the complications of inhaled bodies?

Answer 22

Pmeumonia
Abscess formation
Post- obstructive bronchiecstasis.