Common Cold & Rhinosinusitis

Question 1

the common cold is a _________ infection of the _____

Answer 1

Viral infection of the upper respiratory tract

Question 2

microbes that are commonly involved in the common cold

Answer 2

• rhinovirus: most common in early fall & late spring
• parciinfluenza virus: most common in kids less than 3yrs
• respiratory syneytial virus: peak in winter & spring, common in less than 3
• coronavirus: frequent in winter & spring
• adenovirus: frequent in winter & spring

Question 3

what are the modes of transmission of the common cold

Answer 3

• touch
• nasal & muosa & conjuctival surface
• hand washing decreases the risk of transmission

Question 4

Manifestations of the common cold

Answer 4

• dryness & stuffiness in nasopharynx— excessive production in nasal secretions & tears
• sore throat & hoarsness
• headache & general malaise

Question 5

over the counter medications for the common cold how are the effective or ineffective

Answer 5

• antihistamines: dries nasal secretions, may also dry up bronchial secretions causing a worse cough & may also cause dizziness, drowsiness & impaired judgement
• Decongestants: constricts the blood vessels in the nasal mucosa therefore decreases nasal swelling; these drugs can cause rebound nasal swelling, can also cause systemic vasoconstrciton & an Increase in BP (need to be avoided in pts with high BP, heart disease & DM)
• Vitamin C, Zinz & Echinacea: some studies have shown all these to be benefical others have not

Question 6

what is Rhinosinusitus

Answer 6

-inflammation of the nasal passages & paranasal sinuses

Question 7

what are the sinuses commonly invovled?

Answer 7

frontal, ethmoid, maxillary, sphenoidal

Question 8

what is the patho of rhinosinusitus

Answer 8

narrow openings that communicate with nasal passage comer from each sinus (called Ostia) are obstructed by either a viral upper respiartory infection or an allergic rhinitis. This obstruction causes a problem with mucociliary clearance mechanism (contains mucous surface that lines the sinuses & the ostia in order to clear any foreign body)

Question 9

diagnosing rhinosinusitus

Answer 9

• history & physical exam (of nose & throat)
• sinusitus headache (worse when bending forward, coughing, sneezing
• if actue: turbinate edema, nasal crusts, purulence of nasal cavity & failure of transillumination of maxillary sinuses

Question 10

treating rhinosinusitus

Answer 10

• appropriate use of antibiotics (only to be used after 7 days of symptoms with signs of clearing)
• ,may use topical corticosteriods & mucolytic agents

Question 11

what are two types of serious complications that may arise with rhinosinusitus

Answer 11

• intraorbital complications

- intracranial complications

Question 12

Intraorbital complications from rhinosinusitus

Answer 12

-edema of eyelids to orbital celluitius & superiosteal abscess

Question 13

Intracranial complications from rhinosinusitus

Answer 13

• occur more freqently with infections to frontal & ethomoid sinuses because of proximity to dura & venous drainage
• may see facial swelling over sinus that is affected
• abnormal extraocular movements, protrusion of eyeball, periorbital edema