D & N OF THE NOSE, PARANASAL SINUSES & FACE 1.2 (AB)

Question 1

What is the duration requirement for diagnosing Chronic Rhinosinusitis?

Answer 1

At least 12 weeks.

Question 2

What are the two types of Chronic Rhinosinusitis?

Answer 2

CRS without nasal polyps and CRS with nasal polyps.

Question 3

Which symptoms must be present to diagnose CRS?

Answer 3

Two or more symptoms with at least nasal blockage or nasal discharge.

Question 4

What are the four possible symptoms of CRS?

Answer 4

Nasal blockage. Nasal discharge. Facial pain or pressure. Loss of smell.

Question 5

What objective evidences support a CRS diagnosis?

Answer 5

Mucopurulent discharge. Nasal polyps. Edema or mucosal obstruction. CT scan changes.

Question 6

What is the first-line confirmatory test for CRS?

Answer 6

Nasal endoscopy.

Question 7

When is high resolution CT scan indicated in CRS?

Answer 7

To confirm diagnosis or in prolonged. complicated cases or pre-surgery.

Question 8

What are alternative diagnostic tests for CRS?

Answer 8

Maxillary aspirate. Middle meatal swab. Allergy testing. Rhinomanometry.

Question 9

What is the primary treatment for CRS without nasal polyps?

Answer 9

Intranasal corticosteroids.

Question 10

Which medications are recommended short-term antibiotics for CRS without NP?

Answer 10

Amoxicillin-clavulanic acid. Cefuroxime axetil. Ciprofloxacin.

Question 11

What adjunct therapy may be used for CRS without NP with severe disease?

Answer 11

Short-term oral steroids.

Question 12

What are the recommended long-term low-dose macrolide regimens for CRS without NP?

Answer 12

Roxithromycin 150mg daily. Clarithromycin 250-500mg daily for 12 weeks.

Question 13

When is surgery considered for CRS?

Answer 13

Failure of medical management.

Question 14

What is the mainstay treatment for CRS with nasal polyps?

Answer 14

Intranasal corticosteroids.

Question 15

Name two INCS options for CRS with nasal polyps.

Answer 15

Fluticasone propionate. Mometasone furoate.

Question 16

When are short-term oral steroids used in CRS with NP?

Answer 16

As adjunct for polyp size reduction and symptom relief.

Question 17

What is the recommended oral steroid regimen for CRS with NP?

Answer 17

Prednisolone 25mg daily for 2 weeks. Prednisone tapering. Methylprednisolone regimens.

Question 18

What long-term macrolide therapy may be used for CRS with NP?

Answer 18

Clarithromycin 400mg. Roxithromycin 150mg. Doxycycline. Leukotriene receptor antagonist.

Question 19

What is the definitive treatment if medical therapy fails in CRS with NP?

Answer 19

Surgery.

Question 20

What is Inverted Papilloma?

Answer 20

A locally aggressive benign tumor of sinonasal tract with malignant potential.

Question 21

Which virus is associated with Inverted Papilloma?

Answer 21

HPV 16 and 18.

Question 22

What is the common presentation of Inverted Papilloma?

Answer 22

Unilateral nasal obstruction with watery rhinorrhea.

Question 23

Where does Inverted Papilloma commonly arise?

Answer 23

Lateral nasal wall and maxillary sinus.

Question 24

What is the only way to confirm diagnosis of Inverted Papilloma?

Answer 24

Histologic examination.

Question 25

What does nasal endoscopy show in Inverted Papilloma?

Answer 25

Pale polypoid lesion with papillary appearance from middle meatus.

Question 26

What imaging is used for Inverted Papilloma?

Answer 26

CT scan and MRI.

Question 27

What is the treatment for Inverted Papilloma?

Answer 27

Surgical removal in subperiosteal plane.

Question 28

What is the most common benign sinonasal tumor?

Answer 28

Osteoma.

Question 29

Where are osteomas commonly found?

Answer 29

Ethmoid cells and frontal sinus.

Question 30

When are osteomas treated surgically?

Answer 30

When they become symptomatic and obstruct drainage.

Question 31

What is the main imaging modality for osteomas?

Answer 31

CT scan.

Question 32

What is Juvenile Nasopharyngeal Angiofibroma?

Answer 32

Benign but locally aggressive vascular tumor in male adolescents.

Question 33

What age and sex is most affected by Juvenile Nasopharyngeal Angiofibroma?

Answer 33

Males aged 10-25 years.

Question 34

Where does JNA originate?

Answer 34

Superior margin of sphenopalatine foramen.

Question 35

What are typical symptoms of JNA?

Answer 35

Unilateral nasal obstruction. Epistaxis. Facial swelling. Proptosis. Diplopia.

Question 36

What is the pathognomonic radiologic sign for JNA?

Answer 36

Anterior bowing of posterior maxillary sinus wall. Holman Miller sign.

Question 37

What is the main treatment for JNA?

Answer 37

Surgical removal.

Question 38

What determines the surgical approach for JNA?

Answer 38

Tumor location and extent.

Question 39

What are the key pathological features of JNA?

Answer 39

Fibrous stroma. Spindle or stellate cells. Irregular blood vessels.

Question 40

What is the most common type of sinonasal malignancy?

Answer 40

Squamous cell carcinoma.

Question 41

What are less common sinonasal malignancies?

Answer 41

Adenocarcinoma. Adenoid cystic carcinoma. Osteosarcoma. Lymphoma.

Question 42

What is the most commonly involved sinus in malignancy?

Answer 42

Maxillary sinus.

Question 43

What symptoms suggest a sinonasal malignancy?

Answer 43

Nasal obstruction. Bloody rhinorrhea. Fetid odor. Facial swelling. Diplopia. Numbness.

Question 44

What imaging is used for sinonasal malignancy staging?

Answer 44

CT and MRI.

Question 45

How is sinonasal malignancy diagnosed?

Answer 45

Endoscopy. Imaging. Histology. LN palpation.

Question 46

What is the standard treatment for sinonasal malignancies?

Answer 46

Surgery and postoperative radiation.

Question 47

When is neck dissection indicated for sinonasal malignancies?

Answer 47

Only with clinically positive cervical nodes.