Upper Airway Disorders Flashcards
1
Q
how many paired sinuses in sinus anatomy?
A
- 4
2
Q
how many turbinates or concha
A
- 3-4
3
Q
what is the main epithelium of the mucosal lined surfaces in the sinus
A
- psueodostratified columnar ciliated epithelium
4
Q
respiratory cilia are effective in transporting
A
- mucus
- trapped inhaled particles
- bacteria
5
Q
respiratory cilia are altered by what kind of changes
A
- chemical
- thermal
- mechanical
- hormonal
- pH
6
Q
rhinosinusitis is characterized by
A
- inflammation of the mucosa of the paranasal sinuses
7
Q
3 cardinal symptoms of rhinosinusitis
A
- purulent rhinorrhea
- facial pain/pressure
- nasal obstruction
8
Q
which classification of rhinosinusitis lasts up to 4 weeks, with total resolution of symptoms
A
- acute
9
Q
which classification of rhinosinusitis persists more than 4 weeks, but less than 12 weeks, with total resolution of symptoms
A
- subacute
10
Q
which classification of rhinosinusitis lasts 12 weeks or more of signs/symptoms?
A
- chronic
11
Q
which classification of rhinosinusitis has 4 or more episodes per year, with resolution of symptoms between attacks
A
- recurrent acute
12
Q
most common cause of acute rhinosinusitis
A
- viral
13
Q
viral causes acute rhinosinusitis
A
- rhinovirus
- coronavirus
- influenza
- RSV
- parainfluenza
14
Q
most common bacterial causes of acute rhinosinusitis
A
- streptococcus pnuemoniae
- haemophilus influenzae
- moraxella catarrhalis
15
Q
treatment of acute rhinosinusitis
A
- symptom management
16
Q
treatment of acute rhinosinusitis with persistent or severe symptoms
A
- 10-14 days of antibiotics
17
Q
result of intranasal steroid for treatment of acute rhinosinusitis
A
- may reduce time and intensity of symptoms
18
Q
result of saline irrigations and nasal decongestants for treatment of acute rhinosinusitis
A
- improve symptoms
19
Q
complications of acute sinusitis
A
- loss of anatomic border
- hematologic spread
20
Q
chronic rhinosinusitis is considered more of an ________ disorder than ___________ like ARS
A
- considered more of an inflammatory disorder than an infectious disorder
21
Q
classification of chronic rhinosinusitis (CRS)
A
- CRS without nasal polyposis
- CRS with nasal polyposis
22
Q
symptom based diagnosis of CRS
A
- unreliable
23
Q
gold standard diagnosis of CRS
A
- computed tomography (CT)
24
Q
predisposing factors for CRS
A
- systemic
- local
- microorganisms
- pollutants
- medications
25
most common predisposing factor in CRS
- allergies
| - IgE mediated
26
allergic rhinitis leads to
- mucosal inflammation and hypertrophy
- blocking the ostiomeatal complex
- nonaeration of sinus cavity
- additional inflammation
27
genetic predisposition to chronic sinusitis
- primary ciliary dyskinesia
| - cystic fibrosis
28
primary ciliary dyskinesia genetic pattern
- autosomal recessive
29
result of primary ciliary dyskinesia
- disorganized microtubules
| - absent dynein arms
30
what is the name of the condition where the organs are on the opposite side of the body?
- situs inversus
31
conditions suffered by those with primary ciliary dyskinesia
- chronic sinusitis
- bronchiectasis
- pneumonia
- otitis media
- infertility
- situs inversus
32
indications for Kartagener's syndrome
- situs inversus
- nasal polyps (sinusitis)
- bronchiectasis
33
conditions suffered by those with cystic fibrosis
- bilateral nasal polyps
| - chronic sinusitis
34
common bacterial cause of cystic fibrosis
- pseudomonas aeruginosa
35
mechanical treatment of CRS
- saline irrigations
| - mucolytics
36
result of saline irrigations in treatment of CRS
- increase mucociliary flow
| - mechanically rinse
37
anti-inflammatory treatment of CRS
- antihistamine
- oral corticosteroids
- topical steroids
38
result of topical steroids in treatment of CRS
- improve latency of ostiomeatal complex
| - reduce mucosal swelling
39
antimicrobial treatment of CRS based on
- culture results
40
antimicrobial treatment of CRS treatment duration
- 3-6 weeks
41
systemic conditions of sinuses
- granulomatosis with polyangitis
| - sarcoidosis
42
cause of granulomatosis with polyangitis
- idiopathic vasculitis and autoimmune process
43
result of granulomatosis with polyangitis
- necrotizing granulomas
44
result of sarcoidosis
- chronic granulomatous disease
| - primary pulmonary
45
allergic fungal sinusitis is a subset of
- CRS
46
allergic fungal sinusitis due to
- allergic mucin
- eosinophils
- fungal hyphae
47
treatment of allergic fungal sinusitis
- primarily surgical
| - postop medical treatment
48
result invasive fungal sinusitis
- ENT emergency
49
invasive fungal sinusitis most commonly impacts which population
- immunocompromised individuals
50
invasive fungal sinusitis caused by which organisms
- rhizopus
- mucor
- aspergillus
51
treatment of invasive fungal sinusitis
- surgical debridement
- IV antifungals
- reverse immunocompromised state
52
indications for functional endoscopic sinus surgery
- disease refractory to medical management
| - anatomic obstruction resulting in CRS
53
goals of functional endoscopic sinus surgery
- remove inflammatory mediator load
- restore sinus ventilation/drainage
- restore mucociliary clearance system
- preserve functional integrity of mucosa
54
is surgery a cure for CRS
- no
55
worrisome symptoms for a sinonasal tumor
- frequent, unexplained nosebleeds
- sinonasal discharge
- sinus pain
- visual changes
- neck nodes
- excessive tearing
56
common symptoms of pharyngiitis
- sore throat
| - inflammation of the pharynx
57
most common etiology of pharyngitis
- viral
58
CENTOR criteria symptoms for bacterial pharyngitis
- severe sore throat with fever
- lymphadenopathy
- tonsillar exudate
- absence of cough
59
most common cause of bacterial pharyngitis in adults
- Group A beta hemolytic streptococcus pyogenes
60
physical exam findings of pharyngitis
- erythema and white tonsillar exudates
- petechiae on the soft palate
- swollen tonsils
- bad breath
61
treatment of bacterial pharyngitis
- penicillin or amoxicillin X 10 days
62
what treatment for bacterial pharyngitis do we give for those allergic to penicillin
- macrolide or clindamycin
63
complications of bacterial pharyngitis
- post-streptococcal glomerulonephritis
| - acute rheumatic fever
64
common cold viruses that cause pharyngitis
- rhinovirus
- coronavirus
- parainfluenzae
- influenza virus A, B, C
65
other viral causes of viral pharyngitis
- HIV
- adenovirs
- coxsackivirus
- HSV
66
monospot test is accurate when after EBV infection
- 2-3 weeks after sore throat
67
treatment of mono
- supportive care
- rest
- anti-pyretics
- analgesics
68
what should people with mono avoid
- contact sports
69
what antibiotics do we not give for mono
why
- ampicillin amoxicillin
| - cause maculopapular rash
70
peritonsillar abscesses occur where
- between capsule of tonsils and pharyngeal constrictors
71
peritonsillar abscess associated with what symptoms
- trismus (lockjaw)
- hot potato voice
- drooling
72
treatment of peritonsillar abscess
- incision and drainage
| - antibiotics
73
complications of untreated peritonsillar abscess
- airway obstruction
- necrotizing mediastinitis
- carotid artery aneurysm
- lemierre's syndrome
74
retropharyngeal abscess extends where
- superiorly to base of skull
| - inferiorly to mediastinum
75
characteristic symptom of retropharyngeal abscess
- neck stiffness
| - shortness of breath
76
cause of retropharyngeal abscess
- polymicrobial
| - aerobic/anaerobic gram neg
77
treatment of retropharyngeal abscess
- incision and drainage
| - antibiotics
78
complications of retropharyngeal abscess
- mediastinitis
- airway obstruction
- lemiere's
- necrotizing fasciitis
- sepsis
79
where is the danger space located
- between alar fascia and prevertebral fascia
80
result of Ludwig's angina
- inflammation and cellulitis of the submandibular space
- floor of mouth becomes indurated
- tongue forced upward and backward and obstructs
81
how does Ludwig's angina spread to the sublingual space
- via fascial planes
82
source of Ludwig's angina
- typically dental in origin
83
main symptom of Ludwig's angina
- compromised airway due to displacement of the tongue
84
treatment of ludwig's angina
- tracheotomy
- IV antibiotics
- incision and drainage
85
bacterial causes of ludwig's angina
- strep
- staph
- bacteriodes
86
what is lemierre's
- internal jugular vein thrombosis
