Nose MDT Flashcards

1
Q

Main source of posterior nosebleed

A

Sphenopalatine artery

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2
Q

Symptoms and physical exam:

Acute, unilateral bleed from the anterior nasal cavity (most common)

High blood pressures

A

Epistaxis

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3
Q

Labs/studies for:

Epistaxis

A

Coagulation tests:

  • PT
  • aPtt
  • TT
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4
Q

Treatment for:

Epistaxis

A

Direct pressure by compression of the nares continuously for 15 minutes

Short acting decongestants (phenylephrine)

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5
Q

Treatment for:

Inaccessible epistaxis

A

Packing

Anti-staph antibiotics (reduce toxic shock syndrome from packing)
-Cephalexin or Clindamycin

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6
Q

Benign nasal tumors arising from the mucosa of the nasal passages including the paranasal sinuses. Pale, most commonly semitransparent, edematous, mucosally covered masses commonly seen in patients with allergic rhinitis.

May result in chronic nasal obstruction and a diminished sense of smell

A

Nasal polyps

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7
Q

Plays a triggering role in nasal polyps

A

Infectious agents causing desquamation of the mucous membrane

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8
Q

Strongly associated with nasal polyps

A

Food allergies

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9
Q

In 20% to 50% of patients with polyps

A

Asthma

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10
Q

In 8-26% of patients with polyps

A

Aspirin intolerance

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11
Q

Occurs in 50% of patients with polyps

A

Alcohol intolerance

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12
Q

Labs/studies for:

Nasal polyps

A

CT of the nose and paranasal sinuses (evaluate extent of lesion)

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13
Q

Treatment for:

Nasal polyps

A

Corticosteroids:
Topical (fluticasone nasal for 1-3 months)
Oral (prednisone for 6 days)

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14
Q

Treatment for:

Recurrent polyposis (infections)

A

Remove polyps from the sinuses

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15
Q

Most frequently fractured bone in the body

A

Nasal pyramid (frontal bone, frontal process of maxilla, and perpendicular plate of the ethmoid bone)

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16
Q

Labs/studies:

Nasal trauma

A

Radiologic

Facial bone CT to exclude orbitals

17
Q

Treatment for:

Nasal trauma

A

Acetaminophen

Nasal packing for epistaxis

Extreme nasal displacement: Emergency consult to ENT

18
Q

Seasonal allergic rhinitis - usually caused by airborne allergens such as pollen

A

Hay fever

19
Q

Perennial allergic rhinitis is usually caused by:

A

Dust mites

Animal dander

Mold

20
Q

Immunoglobulin E mediated inflammatory response in the nasal mucosa that occurs after sensitization with a specific allergen

A

Allergic rhinitis

21
Q

Symptoms and physical exam:

  • Nose: Clear rhinorrhea, nasal pruritus, and sneezing, pale turbinates, nasal polyps
  • Eye: Irritation, pruritus, conjunctival erythema, and excessive tearing
  • Cough, bronchospasm, wheezing, dermatitis
  • Allergen exposure
A

Rhinitis

22
Q

Treatment for:

Rhinitis

A

Topical intranasal corticosteroids (flonase or nasonex) for 1-3 months

Antihistamines

Adjunctive treatments:

  • Leukotriene Inhibitors (montelukast)
  • Mass cell stabilizer (cromolyn)
  • Intranasal anticholinergic agents (ipratropium bromide)
23
Q

Follow up and patient education for:

Rhinitis

A

May be a delay in onset of relief of two or more weeks

24
Q

Inflammation of mucous membrane of one or more paranasal sinuses. May be caused by microbial infection, allergic reactions, polyps, or severely deviated septum

Inflammation or an obstruction blocks drainage of mucus into the nasal cavity, fluid pressure builds up in the paranasal sinuses

A

Sinusitis

25
Q

Typical pathogens of bacterial rhinosinusitis are:

A

Strep pneumoniae

Streptococci H influenzae

Less common:
-Staph aureus and Moraxella Catarrhalis

26
Q

Symptoms and physical exam:

  • Purulent yellow-green nasal discharge or expectoration
  • Facial pain or pressure over the affected sinuses
  • Nasal obstruction
  • Acute onset of symptoms (1-4 weeks duration)
  • Associated cough, malaise, fever, and headache
A

Sinusitis

27
Q

Labs/studies for:

Sinusitis

A

Imaging (when difficult to evaluate)

Endoscopic or transantral cultures (complicated causes)

28
Q

Treatment for:

Sinusitis

A

NSAIDS for pain

Oral or nasal decongestants (or both)

Intranasal corticosteroids

Antibiotics (fever, pain, purulent discharge sx for >10 days)

29
Q

Antibiotic treatment for:

Severe sinusitis

A

High dose Amoxicillin/Clavulanate 2g/125mg

PCN allergy: Doxycycline