Brainscape's Knowledge GenomeTM

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


See full index

PHA 521 > NOSE AND SINUS > Flashcards

NOSE AND SINUS Flashcards

1
Q

URI

A

most frequent acute illness in US

preschool children:
5-7 episodes/yr

adults:
2-3 episodes/yr

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

Common Cold: etiology

A

most common: rhinovirus

over 200 viral subtypes

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

Common Cold: risk factors

A

daycare
at home parents
psychological stress
poor sleep

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

Common Cold: more severe infections

A

chronic disease
immunodeficiency
malnutrition
cigarette smoking

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

Common Cold: clinical presentation

A 
rhinitis
nasal congestion 
sore throat
cough
sneezing
malaise
\+/- fever
\+/- conjunctivitis 
watery eyes
headache (mild)
myalgias (mild)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Common Cold: typical presentation

A

incubation: 2-3d
duration: 7-10d

day 1: sore throat
day 2-3: nasal congestions, runny nose
day 4-5: cough

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

Common Cold: physical exam findings

A 
nasal mucosal edema
nasal congestion
pharyngeal erythema
\+/- adenopathy
lungs clear
\+/- conjunctival injection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Common Cold: diagnosis

A

H&P - clinical diagnosis

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

Common Cold: complications

A 
viral sinusitis
bacterial sinusitis 
lower respiratory disease
acute asthma exacerbation
acute otitis media
eustachian tube dysfunction/transient middle ear effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Common Cold: treatment

A 
supportive care
-fluids
-rest
patient education
-duration
-no antibiotics
medications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acute Rhinosinusitis

A

women > men
adults > children

4 weeks or less

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

Acute Rhinosinusitis: etiology

A

VIRAL

  • rhinovirus
  • influenza
  • parainfluenza

<2% bacterial

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

Acute Rhinosinusitis: risk factors

A 
older age
smoking
air travel
changes in atmospheric pressure
swimming
asthma
allergies
dental disease
immunodeficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acute Rhinosinusitis: symptoms

A

nasal congestion/obstruction
purulent nasal discharge
facial pain or pressure

maxillary tooth discomfort
fever
fatigue
hyposmia or anosmia 
ear pressure or fullness
headache
halitosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acute Rhinosinusitis: signs

A

cheek tenderness
purulent drainage in nose or pharynx
sinus pain with percussion
opacity of sinuses with transillumination

erythema or edema of cheekbone or periorbital
percussion of upper teeth tenderness
diffuse nasal mucosa edema, turbinate hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Acute Rhinosinusitis: red flags

A 
fever > 102 with severe headache
abnormal vision
changed mental status
periorbital edema or erythema
cranial nerve palsies
altered mental status
neck stiffness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acute Rhinosinusitis: bacterial

A

10+ days with no improvement

onset with severe symptoms lasting at least 3 consecutive days

double worsening: viral was improving then onset of worsening symptoms

18
Q

Acute Rhinosinusitis: treatment

A

Day 1-9: supportive care

Amoxicillin clavulanate (5-7 days)

Not recommended

  • macrolide (z pak)
  • trimethroprim-sulfamethoxazole (bactrim)

refer

19
Q

Acute Rhinosinusitis: complications

A

periorbital or orbital cellulitis
meningitis
osteomyelitis of sinus bones
intracranial abscess

20
Q

Chronic Rhinosinusitis: clinical presentation

A

12+ weeks

nasal mucopurulent drainage
nasal obstruction/congestion
facial pain/pressure
reduction/loss of smell

polyps

21
Q

Chronic Rhinosinusitis: management

A

nasal irrigation

glucocorticoids
antimicrobials
antileukotriene agents
endoscopic sinus surgery

22
Q

Allergic Rhinitis: risk factors

A 
family hx atopy 
male 
born during pollen season
first born
early use antibiotics
maternal smoking in first year of life
indoor allergen exposure
high IgE before 6yo
allergen specific IgE
23
Q

Allergic Rhinitis: pathophysiology

A

abnormal immune response to an environmental protein

24
Q

Allergic Rhinitis: classification

A

intermittent (<4d/wk, <4wks)
persistent (>4d/wk, >4wks)

mild
moderate-severe

seasonal
perennial

25
Q

Allergic Rhinitis: clinical manifestations

A 
sneezing
rhinorrhea
postnasal drip
fatigue
eye itching, tearing, burning 
allergic shiners
allergic salute
pale blue nasal mucosa
clear rhinorrhea
cobblestoning
TM retraction or serous fluid behind TM
26
Q

Allergic Rhinitis: diagnosis

A

clinical diagnosis

labs
allergy skin testing
serum IgE

27
Q

Allergic Rhinitis: medication options

A

glucocorticoid nasal spray

oral antihistamines
+/-decongestant

mast cell stabilizer

leukotriene receptor agonist

ipratorpium bromide nasal

nasal decongestant spray

no systemic glucocorticoids

28
Q

Nonallergic Rhinitis: etiology

A

abnormal autonomic regulation of innervation of nose

nasal eosinophilia without allergen sensitivity

no identifiable exposure

29
Q

Nonallergic Rhinitis: triggers

A

temperature changes
eating
exposure to odors/chemicals
alcohol use

30
Q

Nonallergic Rhinitis: clinical presentation

A

nasal congestion

postnasal drainage

boggy edematous nasal turbinates

31
Q

Nonallergic Rhinitis: treatment

A

intranasal glucocorticoids

antihistamine

32
Q

Epistaxis

A

95% anterior bleed

5% posterior bleed

33
Q

Epistaxis: treatment

A

conservative

  • occlusion
  • lean forward
  • cold compress

cautery

nasal packing

34
Q

Epistaxis: persistent bleeding

A

contralateral packing
ENT consultation

posterior = emergency

35
Q

Nasal Polyps

A

unclear etiology

associated with

  • allergic rhinitis
  • asthma
  • cystic fibrosis
36
Q

Samter Triad

A

immunologic salicylate sensitivity causes severe episode of bronchospasm

nasal polyps + asthma = no aspirin

37
Q

Nasal Polyps: clinical presentation

A 
nasal obstruction
anosmia
rhinorrhea
post nasal drip
pale, edematous, mucus covered mass
38
Q

Nasal Polyps: treatment

A

intranasal glucocorticoid

surgical excision (high recurrence)

39
Q

Malignant Neoplasms

A

squamous cell carcinoma and adenocarcinoma

rare

male > female
50+ yo

40
Q

Malignant Neoplasms: risk factors

A

tobacco smoke
exposure to wood dust, glue, adhesives
HPV

41
Q

Malignant Neoplasms: presentation

A

obstruction

epistaxis

42
Q

Malignant Neoplasms: diagnosis

A

biopsy

CT, MRI

PHA 521 (12 decks)

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