Nose

Question 1

What is acute sinusitis?

Answer 1

Inflammation of the mucous membranes of the paranasal sinus

Question 2

What are the main cause of acute sinusitis?

Answer 2

Streptococcus pneumoniae
Haemophilus influenzae
Rhinoviruses.

Question 3

What is the characteristic feature of acute sinusitis?

Answer 3

Facial pain- worse on bending forward

Question 4

What 2 nasal signs can occur with acute sinusitis?

Answer 4

Nasal discharge-thick and purulent

Nasal obstruction-polyps

Question 5

What are predisposing factors of acute sinusitis?

Answer 5

Nasal obstruction
Recent local infection
Swimming/diving
Smoking

Question 6

What is the initial management of acute sinusitis?

Answer 6

Analgesia 
Intranasal decongestant (saline)

Question 7

What is the management of acute sinusitis with symptoms for more than 10 days?

Answer 7

Intranasal corticosteroids

Question 8

What would you give if acute sinusitis is severe?

Answer 8

Oral Phenoxymethylpenicillin

Question 9

What is chronic sinusitis?

Answer 9

Inflammatory disorder of the paranasal sinuses that lasts longer than 12 weeks

Question 10

What is the main presentation of chronic sinusitis?

Answer 10

Facial pain that is worse on bending forward

Question 11

What nasal symptoms can you get with chronic sinusitis?

Answer 11

Nasal discharge
Nasal obstruction
Post nasal drip

Question 12

What can a post nasal drip cause in chronic sinusitis?

Answer 12

Chronic cough

Question 13

What does clear nasal discharge suggest?

Answer 13

Allergic reaction

Question 14

What does purulent discharge suggest?

Answer 14

Secondary infection

Question 15

What are red flag symptoms with chronic sinusitis?

Answer 15

Unilateral symptoms
Persistent symptoms despite compliance with 3 months of treatment
Epistaxis

Question 16

What is epistaxis?

Answer 16

Nose bleed

Question 17

What area is usually affected in a nose bleed?

Answer 17

Little’s area

Question 18

What is the presentation of epistaxis?

Answer 18

Unilateral nose bleeding

Vomiting blood-if swallowed

Question 19

What are the primary causes of epistaxis?

Answer 19

Cold
Nose picking-digital trauma
Change in weather
Vigorous nose blowing

Question 20

What are the secondary causes of epistaxis?

Answer 20

Antiplatelet-clopidogrel
Anticoagulant- warfarin
Alcohol
Haemophilia

Question 21

What is the first line management of epistaxis?

Answer 21

Direct compression

Question 22

What would you do secondary to direct compression for epistaxis?

Answer 22

Give naseptin

Question 23

What is the second-line management of epistaxis?

Answer 23

Nasal cautery with silver nitrate

Question 24

What is the third line management of epistaxis?

Answer 24

Nasal packing

Question 25

When would you use nasal packing?

Answer 25

Can't localise the site of bleeding

Question 26

What symptoms does an inorganic foreign body in the nose cause?

Answer 26

Asymptomatic until large enough to cause symptoms

Question 27

What symptoms does an organic foreign body in the nose cause?

Answer 27

Inflammation and secondary infection

Question 28

What is the presentation of an organic foreign body in the nose?

Answer 28

Nasal obstruction Facial pain Unilateral purulent foul smelling discharge

Question 29

What is very dangerous to have stuck in your nose?

Answer 29

Button battery

Question 30

What can a button battery cause?

Answer 30

Necrosis of nasal septum within 4 hours

Question 31

What is the presentation of a button battery in the nose?

Answer 31

Black discharge Epistaxis Facial pain fever

Question 32

What is a button battery in the nose classed as?

Answer 32

A medical emergency

Question 33

What can nasal trauma cause?

Answer 33

Deviation of nasal dorsum | Coalminer dislocation

Question 34

What is the immediate management of nasal trauma?

Answer 34

Ice and analgesia

Question 35

What would you do in 5-7 days after nasal trauma?

Answer 35

Reduce the fracture when the swelling has gone down

Question 36

What would you do months after the nasal trauma?

Answer 36

Rhinoplasty

Question 37

What is a complication of nasal trauma?

Answer 37

Septal haematoma

Question 38

What is a septal haematoma?

Answer 38

Collection of blood between the mucoperichondrial and septum

Question 39

What is the management of a septal haematoma?

Answer 39

Surgical drainage | IV antibiotics

Question 40

Why would you refer someone with unilateral nasal polyps to ENT?

Answer 40

Unilateral symptoms are a red flag

Question 41

What is Samter's triad?

Answer 41

Asthma Aspirin sensitivity Nasal polyposis

Question 42

What are nasal polyps also associated with?

Answer 42

Cystic Fibrosis | Churg-Strauss syndrome

Question 43

What is the presentation of nasal polyps?

Answer 43

Nasal obstruction Rhinorrhoea, sneezing Poor sense of taste and smell

Question 44

How are nasal polyps diagnosed?

Answer 44

Referral to ENT for full examination

Question 45

What is the management for nasal polyps?

Answer 45

Topical corticosteroids

Question 46

What is allergic rhinitis?

Answer 46

Inflammatory disorder where the nose become sensitized to allergens

Question 47

What allergens can the nose become sensitised to in allergic rhinitis?

Answer 47

House dust mites | Grass, tree and weed pollen

Question 48

What mediated response is there in allergic rhinitis?

Answer 48

IgE mediated response

Question 49

What is the presentation of allergic rhinitis?

Answer 49

``` Sneezing Bilateral nasal discharge Post-nasal drip Nasal pruritus Clear nasal discharge ```

Question 50

Why do you get clear nasal discharge in allergic rhinitis?

Answer 50

Because it is an allergic reaction

Question 51

What eye symptom can you get with allergic rhinitis?

Answer 51

Allergic conjunctivitis | red, puffy, watering eyes

Question 52

What is the diagnosis of allergic rhinitis?

Answer 52

History and examination

Question 53

What is the gold standard for allergic rhinitis?

Answer 53

Nasal allergen challenge | not normally done

Question 54

What is the management of allergic rhinitis?

Answer 54

Allergen avoidance

Question 55

What would you give for mild to moderate allergic rhinitis?

Answer 55

Oral or intranasal antihistamines

Question 56

What would you give for moderate to severe allergic rhinitis?

Answer 56

Intranasal steroids