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Respiratory Exam 1 > Upper Airway Disorders > Flashcards

Upper Airway Disorders Flashcards

1
Q

how many paired sinuses in sinus anatomy?

A
  • 4
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2
Q

how many turbinates or concha

A
  • 3-4
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3
Q

what is the main epithelium of the mucosal lined surfaces in the sinus

A
  • psueodostratified columnar ciliated epithelium
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4
Q

respiratory cilia are effective in transporting

A
  • mucus
  • trapped inhaled particles
  • bacteria
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5
Q

respiratory cilia are altered by what kind of changes

A
  • chemical
  • thermal
  • mechanical
  • hormonal
  • pH
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6
Q

rhinosinusitis is characterized by

A
  • inflammation of the mucosa of the paranasal sinuses
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7
Q

3 cardinal symptoms of rhinosinusitis

A
  • purulent rhinorrhea
  • facial pain/pressure
  • nasal obstruction
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8
Q

which classification of rhinosinusitis lasts up to 4 weeks, with total resolution of symptoms

A
  • acute
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9
Q

which classification of rhinosinusitis persists more than 4 weeks, but less than 12 weeks, with total resolution of symptoms

A
  • subacute
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10
Q

which classification of rhinosinusitis lasts 12 weeks or more of signs/symptoms?

A
  • chronic
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11
Q

which classification of rhinosinusitis has 4 or more episodes per year, with resolution of symptoms between attacks

A
  • recurrent acute
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12
Q

most common cause of acute rhinosinusitis

A
  • viral
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13
Q

viral causes acute rhinosinusitis

A
  • rhinovirus
  • coronavirus
  • influenza
  • RSV
  • parainfluenza
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14
Q

most common bacterial causes of acute rhinosinusitis

A
  • streptococcus pnuemoniae
  • haemophilus influenzae
  • moraxella catarrhalis
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15
Q

treatment of acute rhinosinusitis

A
  • symptom management
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16
Q

treatment of acute rhinosinusitis with persistent or severe symptoms

A
  • 10-14 days of antibiotics
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17
Q

result of intranasal steroid for treatment of acute rhinosinusitis

A
  • may reduce time and intensity of symptoms
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18
Q

result of saline irrigations and nasal decongestants for treatment of acute rhinosinusitis

A
  • improve symptoms
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19
Q

complications of acute sinusitis

A
  • loss of anatomic border

- hematologic spread

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20
Q

chronic rhinosinusitis is considered more of an ________ disorder than ___________ like ARS

A
  • considered more of an inflammatory disorder than an infectious disorder
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21
Q

classification of chronic rhinosinusitis (CRS)

A
  • CRS without nasal polyposis

- CRS with nasal polyposis

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22
Q

symptom based diagnosis of CRS

A
  • unreliable
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23
Q

gold standard diagnosis of CRS

A
  • computed tomography (CT)
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24
Q

predisposing factors for CRS

A
  • systemic
  • local
  • microorganisms
  • pollutants
  • medications
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25
Q

most common predisposing factor in CRS

A
  • allergies

- IgE mediated

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26
Q

allergic rhinitis leads to

A
  • mucosal inflammation and hypertrophy
  • blocking the ostiomeatal complex
  • nonaeration of sinus cavity
  • additional inflammation
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27
Q

genetic predisposition to chronic sinusitis

A
  • primary ciliary dyskinesia

- cystic fibrosis

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28
Q

primary ciliary dyskinesia genetic pattern

A
  • autosomal recessive
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29
Q

result of primary ciliary dyskinesia

A
  • disorganized microtubules

- absent dynein arms

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30
Q

what is the name of the condition where the organs are on the opposite side of the body?

A
  • situs inversus
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31
Q

conditions suffered by those with primary ciliary dyskinesia

A
  • chronic sinusitis
  • bronchiectasis
  • pneumonia
  • otitis media
  • infertility
  • situs inversus
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32
Q

indications for Kartagener’s syndrome

A
  • situs inversus
  • nasal polyps (sinusitis)
  • bronchiectasis
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33
Q

conditions suffered by those with cystic fibrosis

A
  • bilateral nasal polyps

- chronic sinusitis

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34
Q

common bacterial cause of cystic fibrosis

A
  • pseudomonas aeruginosa
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35
Q

mechanical treatment of CRS

A
  • saline irrigations

- mucolytics

36
Q

result of saline irrigations in treatment of CRS

A
  • increase mucociliary flow

- mechanically rinse

37
Q

anti-inflammatory treatment of CRS

A
  • antihistamine
  • oral corticosteroids
  • topical steroids
38
Q

result of topical steroids in treatment of CRS

A
  • improve latency of ostiomeatal complex

- reduce mucosal swelling

39
Q

antimicrobial treatment of CRS based on

A
  • culture results
40
Q

antimicrobial treatment of CRS treatment duration

A
  • 3-6 weeks
41
Q

systemic conditions of sinuses

A
  • granulomatosis with polyangitis

- sarcoidosis

42
Q

cause of granulomatosis with polyangitis

A
  • idiopathic vasculitis and autoimmune process
43
Q

result of granulomatosis with polyangitis

A
  • necrotizing granulomas
44
Q

result of sarcoidosis

A
  • chronic granulomatous disease

- primary pulmonary

45
Q

allergic fungal sinusitis is a subset of

A
  • CRS
46
Q

allergic fungal sinusitis due to

A
  • allergic mucin
  • eosinophils
  • fungal hyphae
47
Q

treatment of allergic fungal sinusitis

A
  • primarily surgical

- postop medical treatment

48
Q

result invasive fungal sinusitis

A
  • ENT emergency
49
Q

invasive fungal sinusitis most commonly impacts which population

A
  • immunocompromised individuals
50
Q

invasive fungal sinusitis caused by which organisms

A
  • rhizopus
  • mucor
  • aspergillus
51
Q

treatment of invasive fungal sinusitis

A
  • surgical debridement
  • IV antifungals
  • reverse immunocompromised state
52
Q

indications for functional endoscopic sinus surgery

A
  • disease refractory to medical management

- anatomic obstruction resulting in CRS

53
Q

goals of functional endoscopic sinus surgery

A
  • remove inflammatory mediator load
  • restore sinus ventilation/drainage
  • restore mucociliary clearance system
  • preserve functional integrity of mucosa
54
Q

is surgery a cure for CRS

A
  • no
55
Q

worrisome symptoms for a sinonasal tumor

A
  • frequent, unexplained nosebleeds
  • sinonasal discharge
  • sinus pain
  • visual changes
  • neck nodes
  • excessive tearing
56
Q

common symptoms of pharyngiitis

A
  • sore throat

- inflammation of the pharynx

57
Q

most common etiology of pharyngitis

A
  • viral
58
Q

CENTOR criteria symptoms for bacterial pharyngitis

A
  • severe sore throat with fever
  • lymphadenopathy
  • tonsillar exudate
  • absence of cough
59
Q

most common cause of bacterial pharyngitis in adults

A
  • Group A beta hemolytic streptococcus pyogenes
60
Q

physical exam findings of pharyngitis

A
  • erythema and white tonsillar exudates
  • petechiae on the soft palate
  • swollen tonsils
  • bad breath
61
Q

treatment of bacterial pharyngitis

A
  • penicillin or amoxicillin X 10 days
62
Q

what treatment for bacterial pharyngitis do we give for those allergic to penicillin

A
  • macrolide or clindamycin
63
Q

complications of bacterial pharyngitis

A
  • post-streptococcal glomerulonephritis

- acute rheumatic fever

64
Q

common cold viruses that cause pharyngitis

A
  • rhinovirus
  • coronavirus
  • parainfluenzae
  • influenza virus A, B, C
65
Q

other viral causes of viral pharyngitis

A
  • HIV
  • adenovirs
  • coxsackivirus
  • HSV
66
Q

monospot test is accurate when after EBV infection

A
  • 2-3 weeks after sore throat
67
Q

treatment of mono

A
  • supportive care
  • rest
  • anti-pyretics
  • analgesics
68
Q

what should people with mono avoid

A
  • contact sports
69
Q

what antibiotics do we not give for mono

why

A
  • ampicillin amoxicillin

- cause maculopapular rash

70
Q

peritonsillar abscesses occur where

A
  • between capsule of tonsils and pharyngeal constrictors
71
Q

peritonsillar abscess associated with what symptoms

A
  • trismus (lockjaw)
  • hot potato voice
  • drooling
72
Q

treatment of peritonsillar abscess

A
  • incision and drainage

- antibiotics

73
Q

complications of untreated peritonsillar abscess

A
  • airway obstruction
  • necrotizing mediastinitis
  • carotid artery aneurysm
  • lemierre’s syndrome
74
Q

retropharyngeal abscess extends where

A
  • superiorly to base of skull

- inferiorly to mediastinum

75
Q

characteristic symptom of retropharyngeal abscess

A
  • neck stiffness

- shortness of breath

76
Q

cause of retropharyngeal abscess

A
  • polymicrobial

- aerobic/anaerobic gram neg

77
Q

treatment of retropharyngeal abscess

A
  • incision and drainage

- antibiotics

78
Q

complications of retropharyngeal abscess

A
  • mediastinitis
  • airway obstruction
  • lemiere’s
  • necrotizing fasciitis
  • sepsis
79
Q

where is the danger space located

A
  • between alar fascia and prevertebral fascia
80
Q

result of Ludwig’s angina

A
  • inflammation and cellulitis of the submandibular space
  • floor of mouth becomes indurated
  • tongue forced upward and backward and obstructs
81
Q

how does Ludwig’s angina spread to the sublingual space

A
  • via fascial planes
82
Q

source of Ludwig’s angina

A
  • typically dental in origin
83
Q

main symptom of Ludwig’s angina

A
  • compromised airway due to displacement of the tongue
84
Q

treatment of ludwig’s angina

A
  • tracheotomy
  • IV antibiotics
  • incision and drainage
85
Q

bacterial causes of ludwig’s angina

A
  • strep
  • staph
  • bacteriodes
86
Q

what is lemierre’s

A
  • internal jugular vein thrombosis

Respiratory Exam 1 (27 decks)

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