Stuffy Nose

Question 1

how does histamine affect the nose

Answer 1

vasodilates, irritates nerve endings, causes rhinorrhoea

Question 2

what is ipratropium

Answer 2

anticholingeric

Question 3

what can cause nasal crusting

Answer 3

lots of things inc inflammatory conditions and vasculitis

Question 4

what is halitosis

Answer 4

bad breath

mouth gets dry, bacterial overgrowth

Question 5

what are you looking for in the external nose

Answer 5

swellings, deviations

Question 6

what are the types of rhinitis

Answer 6

infection (viral URTI)
non infective (allergic, non allergic)

Question 7

where can be itchy in allergic rhinitis

Answer 7

nose, eyes, soft palate

Question 8

what can mouth breathing be a sign of

Answer 8

blocked nose, adenoids

Question 9

what causes intermittent and persisitent allergic rhinitis

Answer 9

intermittent (<4 weeks/ <4 days per week)= seasonal (pollen, fungal spores in a/w)

persistent (>4 weeks/ >4 days per week)= house dust mite, cat, dog

Question 10

what is moderate allergic rhinitis

Answer 10

normal sleep

no impact on life or troubling symptoms

Question 11

what is moderate-severe allergic rhinitis

Answer 11

abnormal sleep, impaired life, troublesome symptoms

Question 12

what will the lining of the nose be like in allergic rhinitis

Answer 12

swollen- can appear pink/blue

inflamed and hypertrophied

Question 13

what is the management for allergic rhinitis

Answer 13

allergen avoidance
antihistamines
topical steroids
topcial steroids + antihistamines

immunotherapy
surgery for obstructinon

Question 14

what conditions is often associated with nasal polyps

Answer 14

non allergic asthma

Question 15

how do you treat nasal polyps

Answer 15

oral steroids
topical steroids
surgery

Question 16

how can you differentiate nasal polyps from conchae

Answer 16

nasal polyps have no sensation

Question 17

what are the symptoms of acute infective rhinosinusitis

Answer 17

facial pain, discharge, nasal blockage

Question 18

what usually causes acute infective rhinosinusitis

Answer 18

viral

is an infection of the paranasal sinuses

Question 19

what is the treatment for acute infective rhinosinusitis

Answer 19

analgesics, decongestants

if persisting add antibiotics

Question 20

what are the complications of rhinosinusitis

Answer 20

infection spread into orbit, swelling can put pressure on optic nerve, cause blindness
infection spread into cavernous sinus can thrombose an be fatal

Question 21

what are the types of allergic rhinitis

Answer 21

intermittent and persistent

Question 22

what are the types of non allergic rhinitis

Answer 22

vasomotor rhinitis (parasympathetic problem)
polyps

Question 23

what is rhinosinusitis

Answer 23

infection of the paranasal sinuses

Question 24

what investigations in rhinitis should you not do

Answer 24

nasal/ sinus X-rays

Question 25

what is the management for non infective rhinitis

Answer 25

allergen/ irritant avoidance
change drug therapy
decrease alcohol

topical nasal steroid
antihistamine
topical anticholingeric

Question 26

what is the management for infective rhinosinusitis

Answer 26

nasal decongestant, analgesia

?broad spectrum antibiotic

Question 27

what is the worry is a nasal trauma

Answer 27

a septal haematoma - can cause cartilage and nose to later collapse

Question 28

when should a septal haematoma be evacuated

Answer 28

same/ next day

Question 29

what are the less common causes of a stuffy nose

Answer 29

swollen adenoids
forgein body
mucocele (obstruction of drainage from optic sinus)
tumour in the maxillary sinus

Question 30

what are the signs of a foreign body in the nose

Answer 30

smelly nose that keeps getting blocked

Question 31

what are the signs of a maxillary tumour

Answer 31

can cause teeth to fall out, pain, swelling, stuffy nose

Question 32

what is the management for a child with a foreign body in their nose

Answer 32

refer immediately

Question 33

what is the management for a nasal or paranasal tumour

Answer 33

refer immediately

Question 34

what is a complication of acute sinusitis

Answer 34

orbital cellulitis

Question 35

what is the management for orbital cellulitis

Answer 35

emergency referral (risk of blindness)