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Flashcards in Nose and Paranasal Sinuses Deck (36)
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1
Q

On average, how many URI’s do preschool aged children have per year?

A

5-7 episodes

2
Q

On average, how many URI’s do adults have per year?

A

2-3 episodes

3
Q

Do adults typically have a fever in the setting of URI?

A

No, fever is uncommon in adults

4
Q

What is the diagnosis work-up for URI’s?

A

Clinical diagnosis

5
Q

What are some common physical exam findings of a URI?

A

Conjunctival injection, nasal mucosal swelling, pharyngeal erythema, exudates, cobbelstoning

6
Q

What are risk factors for increased URI severity?

A

Comorbidities
Immunodeficiency
Malnutrition
Smoking

7
Q

What is the most common forms of rhinitis?

A

Allergic rhinitis
Vasomotor rhinitis
Rhinitis medicamentosa

8
Q

What kind of immune response causes allergic rhinitis?

A

IgE response

9
Q

What type of cough maybe present in allergic rhinitis?

A

Dry cough

10
Q

What will be the nasal physical exam findings in allergic rhinitis?

A

Pale, boggy or bluish nasal mucosa (venous engorgement)
“Allergic Salute” in kids

11
Q

What is the role for intranasal corticosteroids when treating allergic rhinitis?

A

Shrink nasal polyps and mucosa

12
Q

In elderly, what nerve sensitivity causes vasomotor rhinitis?

A

Vidian nerve

13
Q

What is the treatment for vasomotor rhinitis?

A

Avoid irritant

14
Q

What is the cause of green boogers?

A

Breakdown of WBC, does not indicate bacterial infection

15
Q

What is the most common etiology of acute sinusitis?

A

Viral infection

16
Q

The typical duration of a viral cause of acute sinusitis is 7-10 days, beyond 10 and symptoms worsening is indicative of what type of infection?

A

Bacterial

17
Q

How do you differentiate a viral acute sinusitis from bacterial?

A

Viral - rhinorrhea may be discolored and will last 7-10 days in duration

Bacterial - Purulent discharge and duration longer than 10 days or high fever

18
Q

What are the most common pathogens of bacterial acute sinusitis?

A

S. pneumoniae
H. influenza
M. catarrhalis
S. pyogenes
S. aureus

19
Q

What is the treatment for bacterial acute sinusitis?

A

Amoxicillin-clavulanate (Augmentum) for 10-14 days (longer time to penetrate sinuses)

If PCN allergy: Doxy

20
Q

What duration of symptoms define chronic sinusitis?

A

> 12 weeks

21
Q

What are the symptoms of chronic sinusitis?

A

Persistent rhinorrhea
Productive cough
foul breath
Low grade fever
Malaise
Headache
Facial/dental apin

22
Q

What is the imaging modality of choice in working up complicated acute bacterial sinusitis?

A

CT scan with contrast

23
Q

What is the most common cause of nasal obstruction in children?

A

Adenoid Hypertrophy

24
Q

What are symptoms of adenoid hypertrophy?

A

Mouth breathing
Mucopurulent discharge
Snoring
Sleep apnea

25
Q

What are clinical manifestations of “adenoid facies?”

A

Open mouth
Flattening and elongation of midface
Retraction of upper lip
Narrowing of hard palate resulting in crowding of teeth

26
Q

What is the treatment of adenoid hypertrophy?

A

Adenoidectomy

27
Q

What is the most common tumor of the nasal cavity?

A

Nasal polyps (benign)

28
Q

What is the treatment for nasal polyps?

A

Steroids (oral, topical, or injections)
Avoid ASA
Surgical excision for larger polyps
Test and treat for allergies

29
Q

Why are we concerned when button batteries are shoved in the nasal cavity?

A

Will result in septal perforation in about 4 hours

30
Q

Approximately 90% of nasal bleeds are

A

anterior

31
Q

Most nasal bleeds are anterior and the most common anterior location for bleeds are in what structure area?

A

Klesselbach’s plexus

32
Q

To stop epitaxis (anterior nose bleed) how long should direct pressure be supplied for?

A

15 minutes

33
Q

What topical medications maybe used to help stop nasal bleeding?

A

Oxymetazoline (Afrin)
Boyette’s solution (4% lidocaine, phenylephrine, NS)

34
Q

What is the treatment for posterior nasal bleeds?

A

Tamponade posterior bleeding (usually done by ENT)

35
Q

What is the most common cause of facial pain?

A

Trigeminal neuralgia

36
Q

Where is pain most often in trigeminal neuralgia?

A

Involves V2 and/or V3 subdivisions of trigeminal nerve