Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SPC- ENT > Nose and sinus problems > Flashcards

Nose and sinus problems Flashcards

1
Q

What can cause obstruction to drainage of paranasal sinuses?

A

Anatomical- septal deviation, polyps

Mucosal- viral infection causing mucosal oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the features of acute bacterial rhinosinusitis?

A

Discoloured discharge and purulent secretion in the nasal cavity
Severe local pain
Fever (>38)
Elevated CRP/ESR
Double sickening- i.e. deterioration after milders symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is swelling a common feature of sinusitis?

A

No- visible swelling is uncommon. Exclude cancers or dental root infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some organisms causing rhinosinusitis?

A

S.pneumoniae
H.infuenzae
S.aureus

98% of causes of are viral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What investigations might be considered for recurrent acute or chronic sinusitis?

A

CT of the paranasal sinuses

Nasal endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the management for acute sinusitis?

A

98% case are viral and self limiting, taking around 2.5 weeks to resolve

Simple analgesia
Nasal saline irrigation
Nasal decongestants e.g.ephedrine 0.5% max 1 week
Intranasal corticosteroids- if severe symptoms or have been present for more than 10 days.

If bacterial infection suspected give ABx- amoxicillin or doxycycline.

Smoking cessation is also beneficial and should be recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What might be done for recurrent sinusitis?

A

Imaging and consideration for surgery- e.g. endoscopic sinus surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some complications of sinusitis?

A

Orbital cellulitis/abscess
Intra-cranial involvement- meningitis, encephalitis, cerebral abscess, cavernous sinus thrombosis
Mucocele- sinus may become a pus filled cavity
Osteomyelitis- bone infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When should intra-nasal corticosteroids be considered for sinusitis

A

If symptoms persist for 10 days or more or the symptoms are severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is sinusitis?

A

Inflammation of the mucosal surfaces of the paranasal sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why might patients who smoke be at increased risk of developing sinusitis?

A

Smoking decreases the motility of the cilia and so decreases clearance which increases the risk of developing infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the symptoms of acute sinusitis?

A

Facial pain- typically frontal pressure pain which worsens when bending forward
Nasal discharge- thick and purulent
Nasal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If a bacterial cause is suspected in acute sinusitis what antibiotics may be prescribed?

A

Phenoxymethylpenicillin

Co-amoxiclav is systemically very unwell, signs and sx of a more serious illness or at high risk of complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some warning flags for cancer of the paranasal sinuses?

A 
Bleeding
Blood stained nasal discharge
Unilateral nasal obstruction
Swelling
Any signs of local invasion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some factors that are associated with nasal polyps?

A 
Asthma- particularly late onset
Aspirin sensitivity
Infective sinusitis
Cystic fibrosis
Kartagener's syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some symptoms of nasal polyps?

A

Nasal obstruction
Rhinorrhoea
Sneezing
Poor sense of taste and smell- a large amount of taste comes from the sense of smell

Polyps are concerning if any of the features are occuring unilaterally

17
Q

What should the management be fore all patients with suspected nasal polyps?

A

Refer to ENT for a full examination as they could be cancerous. Nasal endoscopy will be carried out.

Topical corticosteroids can be used to shrink the polyps in around 80% of patients

18
Q

What is rhinosinusitis?

A

Inflammation of the nasal cavity and paranasal sinuses

19
Q

What are the symptoms of rhinosinusitis?

A 
Blockage
Obstruction
Congestion
Nasal discharge
Facial pain or pressure (esp with sinusitis)
Reduction in sense of taste/smell
20
Q

When might intranasal corticosteroids be considered for acute rhinosinusitis?

A

If symptoms persist for more than 5 days

E.g. Mometasone, fluticasone

Normally this is a self limiting infection

21
Q

What are nasal polyps?

A

Swellings of the nasal or sinus mucosa that prolapses into the nasal cavity

22
Q

Why is a unilateral poly concerning?

A

Polyps usually occur bilaterally and so a unilateral polyp could be a sign of malignancy.

Any persistent unilateral bleeding/obstruction/blood stained discharge is concerning

23
Q

What are the symptoms of nasal polyps with associated chronic rhinosinusitis?

A 
Rhinorrhoea 
Sneezing
Nasal obstruction
Recurrent/chronic sinusitis
Mouth breathing
Snoring
Headaches
24
Q

What should be done for any patient presenting with nasal polyps?

A

Referral to ENT for full evaluation

25
Q

What investigations should be done for nasal polyps?

A

Anterior rhinoscopy
Nasal endoscopy

If there is any suspicion of cancerous lesion/unilateral polyp a biopsy should be taken

26
Q

What are the treatment options for nasal polyps

A

Topical steroid drops/spray e.g. fluticasone, betamethasone

Surgical- Endoscopic sinus surgery to relieve any obstructions

27
Q

Why might nasal polyps be a cause of chronic sinusitis?

A

The outflow from the sinuses is obstructed and this leads to recurrent/chronic infection

28
Q

What are some conditions nasal polyps are associated with?

A 
Allergic rhinitis
Non-allergic rhinitis
Chronic ethmoid sinusitis
Cystic fibrosis
Aspirin hypersensitivity
Asthma
29
Q

What is the management for chronic rhinosinusitis without nasal polyps?

A

Intranasal corticosteroids
Nasal saline irrigation
Consider taking samples for MC+S testing in case of bacterial infection of the mucosa
Surgery if failure of medical therapy

30
Q

What is allergic rhinitis?

A

This is inflammation of the nasal mucosa due to allergic processes. This is IgE mediated allergy.

31
Q

What are some symptoms of allergic rhinitis?

A

Sneezing
Rhinorrhoea
Pruritus
Bilateral itchy and red eyes

32
Q

What is the management for allergic rhinitis?

A

Allergen avoidance where possible

Nasal saline irrigation to wash out the allergens

Antihistamines e.g. Loratadine

Intranasal steroid sprays e.g. Fluticasone

Oral steroids e.g. Prednisolone (short course)

Immunotherapy for severe cases not responding

Desensitisation

33
Q

What are some causes of allergic rhinitis?

A

Pollens
Animal dander
House dust mite

34
Q

What else might you want to ask about in a history for allergic rhinitis?

A

Any history of atopy

e.g. Eczema, Asthma or Allergic Rhinitis

35
Q

What are some other causes of nasal congestion?

A 
Think of any cause of obstruction
Foreign body
Tumour
Large adenoids
Polyps
Deviated nasal septum
36
Q

What type of hypersensitivity reaction is allergic rhinitis?

A

Type I- IgE mediated

37
Q

What can be done to test for the causative organism of allergic rhinitis?

A

Skin prick testing

SPC- ENT (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions