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Specialty Medicine > Nose > Flashcards

Nose Flashcards

1
Q

What is rhinitis medicamentosa?

A

a condition of rebound nasal congestion brought on by extended use of topical decongestants

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2
Q

What is anosmia?

A

s the inability to perceive odor or a lack of functioning olfaction—the loss of the sense of smell.

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3
Q

What is parosmia?

A

an olfactory dysfunction that is characterized by the inability of the brain to properly identify an odor’s “natural” smell

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4
Q

What are the four arteries that form Kiesselbach’s plexus?

A
  • Anterior ethmoidal artery (from the ophthalmic artery)
  • Sphenopalatine artery (terminal branch of the maxillary artery)
  • Greater palatine artery (from the maxillary artery)
  • Septal branch of the superior labial artery (from the facial artery)
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5
Q

What is nasal vestibulitis?

A

The diffuse dermatitis of nasal vestibule. It is often caused by Staphylococcus aureus

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6
Q

What are juvenile nasopharyngeal angiofibromas? Who does it usually affect? What is the classic presentation?

A

Histologically benign but locally aggressive vascular tumor that grows in the back of the nasal cavity. It most commonly affects adolescent males. Patients with nasopharyngeal angiofibroma usually present with one-sided nasal obstruction and recurrent bleeding.

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7
Q

What causes the stuffy nose?

A

Engorgement of the nasal turbinates

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8
Q

What is the role of the nasal turbinates?

A

Humidify the incoming air

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9
Q

What is the uncinate process?

A

Process that sticks out from the lateral wall of the nose, between the inferior and middle turbinate

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10
Q

Which are more common: anterior or posterior nasal bleeds?

A

Anterior, by far

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11
Q

What is the usual presentation of epistaxis?

A

Intermittent, few times a week for a few months

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12
Q

What is the major artery that supplies the posterior nasopharynx?

A

Sphenopalatine

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13
Q

What is the major artery that supplies the anterior/middle nasopharynx?

A

Anterior ethmoid and posterior ethmoid arteries

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14
Q

What is the more appropriate type of drug to use with nasal congestion?

A

Steroid-based

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15
Q

What is the role of HTN in the development of nosebleeds?

A

can play a role, but not a huge factor

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16
Q

What is the defect in von Willebrand’s disease?

A

A qualitative or quantitative deficiency of von Willebrand factor (vWF), which is in endothelial walls, and tethers GPIb

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17
Q

What is the wind tunnel theory of epistaxis?

A

Chronic exposure of narrowed nasopharynx to the dry air leads to drying out

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18
Q

Why is there an increased incidence of epistaxis in the allergy season?

A

Inflammation of the arteries in the nose leaves them susceptible to damage

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19
Q

Most epistaxis is from what arteries?

A

Anterior arteries of Kiesselbach’s plexus

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20
Q

What is the pathogenesis of tears of blood with epistaxis?

A

blood backs up into the lacrimal duct

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21
Q

True or false: bilateral epistaxis is common

A

True, since one side can back up and come down the other side

22
Q

What is the artery the supplies the tiny anterior portion of the nose from the philtrum? What is this a branch of?

A
  • Superior labial artery

- Branch of the maxillary artery

23
Q

What is the artery that supplies the inferior portion of the nasopharynx? What is this a branch of?

A
  • Greater palatine artery

- Branch of the maxillary artery

24
Q

What type of moisturizing agents can be applied to prevent dry noses?

A

Water based lubricants

25
Q

Should nasal spray be continued with chronic dry nose/epistaxis?

A

No

26
Q

What is a good treatment for acute nosebleeds that are not chronically recurrent?

A

Afrin (Oxymetazoline) a selective α1 adrenergic receptor agonist and α2 adrenergic receptor partial agonist

27
Q

What is the role of silver nitrate in treating nasal bleeds?

A

Slow or recurrent bleeds-not actively bleedings

28
Q

What is the general treatment for anterior nasal bleeds?

A

Anesthetize area with injectable lidocaine, then cauterize site

29
Q

How long does nasal packing have to stay in for?

A

3 days

30
Q

Who removes nasal packing?

A

ENT docs

31
Q

What are the abx that should be used with nasal packing? Why?

A
  • anti-staph

- Reports of TSST

32
Q

What is the ultimate treatment for refractory anterior nasal bleeds?

A

Ligation or embolization of the internal maxillary artery

33
Q

What are the general characteristics of posterior epistaxis as compared to anterior?

A

Usually much more rapid, and problematic

34
Q

What is the general treatment for posterior epistaxis?

A

Rhino Rockets

35
Q

What artery can be ligated to treat recurrent posterior epistaxis?

A

Anterior ethmoid

36
Q

Young males with recurrent bleeding need to be evaluated for what?

A

JNA

37
Q

Where do JNA’s sit in the nasopharynx?

A

Posteriorly–in the adenoids

38
Q

What are the most common causes of anosmia?

A

Obstructive etiology or post viral etiology

39
Q

What are the antithyroid drugs that can cause anosmia?

A

PTU

40
Q

What are the two antifungal drugs that can cause anosmia?

A

Amphotericin B

Griseofulvin

41
Q

What is the MOA of griseofulvin?

A

Inhibits microtubules

42
Q

What is the MOA of AMP B?

A

As with other polyene antifungals, amphotericin B binds with ergosterol, a component of fungal cell membranes, forming a transmembrane channel that leads to monovalent ion (K+, Na+, H+ and Cl−) leakage, which is the primary effect leading to fungal cell death.

43
Q

What, generally, is the diagnostic workup for altered smell?

A

CT scan to r/o paranasal path

44
Q

True or false: most cases of anosmia are usually found

A

False

45
Q

What is the medication that can be used to treat an altered sense of smell?

A

Topical nasal steroids

46
Q

What is the usual presentation of nasal vestibulitis?

A

Dry, scabbing, bloody nose

47
Q

What is the usual cause of nasal vestibulitis

A

Dry weather or manual irritation

48
Q

What may result from nasal vestibulitis?

A

Squamous metaplasia

49
Q

What is the treatment for nasal vestibulitis?

A
  • Stop nasal spray and increase humidity

- Mupirocin ointment

50
Q

What are the alternatives to rhinitis medicamentosa?

A

Nasal steroids or turbinoplasty

Specialty Medicine (36 decks)

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