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otolaryngology > Nose Conditions > Flashcards

Nose Conditions Flashcards

1
Q

What are nasal polyps

A

Soft, painless, non-cancerous growths on the lining of the nasal passages

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2
Q

What are nasal polyps often associated with

A

Non-allergic asthma

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3
Q

What do you need to consider in a young patient with nasal polyps

A

Cystic fibrosis

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4
Q

Histology of nasal polyps

A

Lined by respiratory or squamous epithelium
Oedematous stroma containing mixed inflammatory cells +/- eosinophils

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5
Q

Clinical presentation of nasal polyps

A

Blocked nose, runny nose, reduced sense of taste or smell

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6
Q

Investigation for nasal polyps

A

Nasoendoscopy

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7
Q

Management of nasal polyps

A

Intranasal topical steroid

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8
Q

What is allergic rhinitis

A

IgE mediated type 1 hypersensitivity reaction

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9
Q

How do we classify allergic rhinitis

A

Intermittent and persistent

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10
Q

What causes intermittent allergic rhinitis

A

Grass pollen, tree pollen, fungal spores

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11
Q

Intermittent allergic rhinitis

A

Symptoms <4 days per weeks OR symptoms for <4 weeks

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12
Q

Persistent allergic rhinitis

A

Symptoms >4 dats per week AND >4 week duration

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13
Q

What causes persistent allergic rhinitis

A

House dust mite, cat, dog

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14
Q

Clinical presentation of allergic rhinitis

A

Sneezing, nasal itching, nasal congestion and discharge

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15
Q

Sign of allergic rhinitis

A

Allergic crease indicates repeated itching of the nose

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16
Q

What investigations can be done for allergic rhinitis

A

Skin prick test, measure blood IgE

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17
Q

Management of allergic rhinitis

A

ALLERGEN AVOIDANCE
1. Antihistamines
2. Topical corticosteroids
3. immunotherapy e.g. montelukast

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18
Q

What is non-allergic rhinitis

A

Inflammation of the inside of the nose that is not caused by an allergy

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19
Q

Causes of non-allergic rhinitis

A

Viral infection
Vasomotor
Occupational
Hormonal
Drug induced

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20
Q

Name some drugs that can cause non-allergic rhinitis

A

ACEi, b-blockers, NSAIDs, cocaine

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21
Q

What is vasomotor rhinitis caused by

A

Dysfunction of blood vessels and nerves in the nasal passages

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22
Q

Pathophysiology of non-allergic rhinitis

A

Lining of the nose becomes swollen and inflamed blocking the nasal passage and stimulating the mucous glands in the nose

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23
Q

Clinical presentation of non-allergic rhinitis

A

Rhinorrhoea, sneezing, itchy nose, nasal congestion

24
Q

Management of vasomotor rhinitis

A

Consider anticholinergics e.g. ipratropium

25
Q

Management of non-allergic rhinitis

A

Avoidance of triggers
Topical nasal steroids
Antihistamine for itch and sneeze

26
Q

Complications of non-allergic rhinitis

A

Sinusitis, nasal polyps

27
Q

What is acute sinusitis

A

Symptomatic inflammation of the paranasal sinuses lasting less than 12 weeks

28
Q

What usually causes acute sinusitis

A

Most commonly preceded from rhinitis but can spread from dentition

29
Q

Common organisms that cause acute sinusitis

A

Strep.pneumo
H.influenzae
Moraxella catarrhalis

30
Q

Clinical presentation of acute sinusitis

A

Nasal blockage or discharge with facial pain/pressure and reduction in sense of smell

31
Q

Management of acute sinusitis

A

Analgesics and nasal decongestants
Saline irrigation

32
Q

Management of acute sinusitis after 10 days

A

Nasal corticosteroids for symptoms
Antibiotics: phenoxymethylpenicillin
Doxycycline second line

33
Q

Complications of acute sinusitis

A

Spread from sinuses to orbit: cellulitis, periosteal abscess, orbital abscess
Thrombosis of retinal vein or cavernous sinus

34
Q

What is granulomatosis with polyangitis

A

Characterised by a small vessel vasculitis and necrosis, usually limited to the resp tract and kidneys

35
Q

When do patients usually present with granulomatosis with polyangitis

A

> 40

36
Q

Name some ENT features of granulomatosis with polyangitis

A

Sinusitis, nasal crushing, epistaxis, mouth ulcers, sensorineural deafness, otitis media, subglottic inflammation

37
Q

Investigation for granulomatosis with polyangitis

A

cANCA positive

38
Q

What is ANCA

A

Cytoplasmic Anti-neutrophil cytoplasmic antibodies

39
Q

Management of granulomatosis with polyangitis

A

IV steroids and cyclophosphamide

40
Q

Name the most common benign lesion of the nose

A

Squamous cell papilloma

41
Q

Name 4 benign lesions of the nose

A

Squamous cell papilloma
Sinonasal papillomas
Recurrent respiratory papillomatosis
Angiofibroma

42
Q

Who tends to get sinonasal papillomas

A

Men over 50

43
Q

Clinical presentation of sinonasal papilloma

A

Blocked nose

44
Q

What is recurrent respiratory papillomatosis

A

Papilloma form along the aerodigestive tract

45
Q

What is recurrent respiratory papillomatosis associated with

A

HPV

46
Q

How does recurrent respiratory papillomatosis present

A

In children with hoarse voice and progressive SOB

47
Q

What is the most common malignant lesion of the nose

A

Squamous cell carcinoma

48
Q

Where is nasopharyngeal carcinoma usually seen geographically

A

Far east and parts of Africa

49
Q

Which gender has a higher incidence of nasopharyngeal carcinoma

A

Males

50
Q

What does nasopharyngeal carcinoma have a strong association with

A

EBV, volatile nitrosamines in food

51
Q

Name 2 EBV genes which affect normal signalling pathways and how they do it

A

LMP-1 acts as an oncogene
EBNA-2 promotes transition from G0 to G1

52
Q

What is subglottic stenosis

A

Narrowing of the airway below the vocal chords and above the trachea

53
Q

Most common cause of subglottic stenosis

A

Idiopathic

54
Q

What has subglottic stenosis been associated with in adults

A

Vasculitis

55
Q

Clinical presentation of subglottic stenosis

A

Progressive difficulty breathing made worse by exertion

56
Q

Management of subglottic stenosis

A

Division of the stenosis
If recurrent: resection and reconstruction

otolaryngology (18 decks)

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