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Specialty Medicine > Sinus > Flashcards

Sinus Flashcards

1
Q

What is the definition of rhinosinusitis?

A

Inflammation of the nose and the sinuses

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2
Q

What are the s/sx of rhinosinusitis? (4)

A
  • facial pain
  • hyposmia
  • Fever
  • Nasal obstruction
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3
Q

What is the timeframe for acute rhinosinusitis?

A

Up to 4 weeks

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4
Q

What is the timeframe for subacute rhinosinusitis? Chronic?

A

4-12 weeks

12+ weeks = chronic

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5
Q

What is the definition of recurrent acute rhinosinusitis?

A

4 or more episodes / year

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6
Q

True or false: sinusitis typically precedes rhinitis

A

False–other way around

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7
Q

True or false: sinusitis without rhinitis is rare

A

True

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8
Q

The mucus membrane of the nose is continuous down to what part of the respiratory pathway?

A

Tracheobronchial tree

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9
Q

What are the classic s/sx of rhinitis?

A
  • congestion
  • Sneezing
  • Itching
  • Nasal d/c
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10
Q

What is the usual cause of rhinitis/sinusitis?

A

viral etiology with 2/2 bacterial infection a common complication

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11
Q

What are the classic signs of rhinitis/ sinusitis?

A

Discolored nasal containing PMNs

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12
Q

What causes the green coloration of mucus?

A

PMN peroxidase

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13
Q

Purulent d/c for more than how many days suggests bacterial rhinitis and/or rhinosinusitis?

A

5 days

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14
Q

True or false: the color of the sputum is indicative of the etiology of rhinitis/sinusitis?

A

True per him

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15
Q

What are the s/sx of rhinosinusitis?

A
  • Nasal obstruction/congestion
  • d/c / purulence
  • Cough
  • HA
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16
Q

Which sinus in particular can cause sinus HAs?

A

Sphenoid sinuses

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17
Q

True or false: There has to be hearing loss if there is fluid in the ear

A

True

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18
Q

True or false: fever and/or leukocytosis is often present with chronic rhinosinusitis

A

False–uncommon

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19
Q

What are the associated causes of rhinitis?

A

Seasonal allergic issues

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20
Q

What type of secretions are had with allergic rhinitis?

A

Watery rhinorrhea

Repetitive sneezing

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21
Q

True or false: allergic rhinitis plays a significant role in chronic rhinitis

A

True

22
Q

What is the classic presentation of a kid with large adenoids?

A

mouth breathers

23
Q

Chronic adenoiditis mimics what?

A

Rhinosinusitis and allergies

24
Q

What are the symptoms of adenoiditis?

A
  • Nasal congestion
  • Chronic rhinorrhea
  • Chronic cough
25
Q

If a kid under four presents with s/sx consistent with sinusitis, what etiology should be suspected?

A

Adenoids

26
Q

What happens to the adenoids as we age?

A

Shrink, but not always

27
Q

What is the relationship between adenoids and the incidence of OM?

A

If take adenoids out, lowers recurrence rate of OM

28
Q

What happens to the drainage with adenoids with abx treatment?

A

d/c clears, with rapid return of drainage when off of meds

29
Q

True or false: to meet the diagnostic criteria for laryngopharyngeal reflux, kids have to be spitty

A

False

30
Q

What is the relationship between acid reflux and upper airway disease

A

Positive correlation

31
Q

What should be thought of in patients who have recurrent mucosal infections?

A

Immune deficits

32
Q

What are the three major risk factors for the development of upper airway disease in kids?

A
  • Smoking
  • daycare
  • Allergen exposure
33
Q

What is the chronic lower airway condition that predispose kids to rhinosinusitis?

A

Asthma

34
Q

What are the chronic upper airway conditions that predispose kids to rhinosinusitis?

A
  • Eustachian tube dysfunction
  • Nasal polyposis
  • Allergic conjunctivitis
35
Q

What is the role of sinusitis and asthma?

A

Inflammation in the nose may increase lower airway hyperresponsiveness

36
Q

How do you diagnose sinusitis?

A
  • Type of nasal drainage

- Intranasal and pharyngeal exam

37
Q

What is the role of plain films in diagnosing rhinosinusitis?

A

No role

38
Q

What is the role of CT scans in diagnosing rhinosinusitis?

A

For medical failures

39
Q

True or false: WBC is usually normal with chronic sinusitis

A

True

40
Q

What is the role of MRIs in diagnosing rhinosinusitis?

A

Overkill

41
Q

What is the treatment for sinusitis?

A

-Augmentin

42
Q

What is the role of oral steroids in the treatment of sinusitis?

A

Can help calm down acute inflammation

43
Q

How fast do topical steroids work to treat rhinitis?

A

not instant, but relatively fast

44
Q

True or false: topical steroids are used only for chronic sinusitis

A

False–can be used in acute episodes as well

45
Q

What is the treatment of choice for sinusitis 2/2 allergies?

A

Oral antihistamines and Decongestants

46
Q

What are the two major types of topical decongestants for sinusitis?

A

Phenylephrine

Oxymetazoline

47
Q

When does rebound vasodilation occur with topical decongestants?

A

3 days

48
Q

How long does it take for rhinitis medicamentosa to take effect?

A

10 days - 14 days

49
Q

How severe are the risks of adenoidectomy?

A

Safe, with minimal pain and no real long term issues

50
Q

What is the medical therapy for adenoiditis?

A

Prolonged abx or topical steroids

51
Q

What is balloon tech for sinusitis?

A

Insert into sinus and blow up to dilate the bone

52
Q

What is the role of packing for sinusitis?

A

No longer done

Specialty Medicine (36 decks)

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