Lecture 8 - nasal disease intro (Specht)

Question 1

CS that can help localize dz to the nose

Answer 1

increased inspiratory effort
nasal d/c 
sneezing 
upper respiratory sounds; stertor (snoring) 
obligate mouth breathing 
visible lesions

Question 2

nasal dz may have increased __ effort

Answer 2

inspiratory

Question 3

audible nose that localized dz to nose

Answer 3

stertor (snoring)

Question 4

__ implies that the capacity of mucociliary clearance mechanism has been exceeded

Answer 4

nasal d/c

increased production (acute) 
decreased clearance (chronic)

Question 5

common ddx for nasal dz

Answer 5

1 neoplasia 
2 NP polyp 
3 fungal rhinitis (asper, crytpococcus) 
4 feline infectious resp dz (feline URTI); herpes, calic, chlamydiophila, myco
5 FB 
6 tooth root abscess 
7 allergic/LP or idiopathic rhinitis

Question 6

younger patient with nasal CS narrows ddx list to

Answer 6

viral/bacterial
polyp
congenital
dysphagic d/o

Question 7

older patient with nasal CS narrows ddx list to

Answer 7

neoplasia
fungal
allergic/LP rhinitis
dental dz

Question 8

1 thing to ask about the environment when a patient has suspected nasal dz

Answer 8

SMOKING; common cause of nasal dz in animals

Question 9

unilateral nasal d/c could suggest

Answer 9

FB
tooth root abscess
neoplasia (uni and bi)
fungus (uni and bi)

Question 10

bilateral nasal d/c could suggest

Answer 10

rhinitis
bacterial/viral
neoplasia (both)
fungal (both)

Question 11

review notes on dx testing for nasal dz

Answer 11

LOOK UP

Question 12

mucoid d/c

Answer 12

mycotic rhinitis

neoplasia

Question 13

mucopurulent or puruluent nasal d/c

Answer 13

viral/bacterial
neoplasia 
fungal
polyp 
ON fistula 
more ..

Question 14

epistaxis

Answer 14

fungal
neoplasia 
hypertension 
rickettsial dz 
thrombocytopathy/coagulopathy
trauma

Question 15

t/f: the presence of bacteria in nasal secretions is normal

Answer 15

true

Question 16

__ may be useful in cases of nasal cryptococcosis for dx and monitoring tx response

Answer 16

serology (ag test)

Question 17

T/F: a negative titer r/o nasal aspergillus fumigatus

Answer 17

false, does not rule it out!

also an ab titer can support dz but does not confirm it

Question 18

can nasal radiographs or CT provide a specific dx

Answer 18

no!

Question 19

can rhinoscopy give a specific dx?

Answer 19

No (except with FB, or mites)

Question 20

what is the dx test that is most likely to yeild a specific dx if there is a primary nasal dz?

Answer 20

biopsy!

before doing bx of nose get platelet count, PT/PTT, BMBT, BP, and crossmatch bc can bleed profusely

Question 21

in order to prevent penetration of the calvarium via the cribriform plate when taking nasal Bx what should you do

Answer 21

measure the distance btwn nostril and medial canthus of eye with bx instrument, do not advance further than this distance or will bx brain :0 !