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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
Management of non-allergic rhinitis
Avoidance of triggers Topical nasal steroids Antihistamine for itch and sneeze
26
Complications of non-allergic rhinitis
Sinusitis, nasal polyps
27
What is acute sinusitis
Symptomatic inflammation of the paranasal sinuses lasting less than 12 weeks
28
What usually causes acute sinusitis
Most commonly preceded from rhinitis but can spread from dentition
29
Common organisms that cause acute sinusitis
Strep.pneumo H.influenzae Moraxella catarrhalis
30
Clinical presentation of acute sinusitis
Nasal blockage or discharge with facial pain/pressure and reduction in sense of smell
31
Management of acute sinusitis
Analgesics and nasal decongestants Saline irrigation
32
Management of acute sinusitis after 10 days
Nasal corticosteroids for symptoms Antibiotics: phenoxymethylpenicillin Doxycycline second line
33
Complications of acute sinusitis
Spread from sinuses to orbit: cellulitis, periosteal abscess, orbital abscess Thrombosis of retinal vein or cavernous sinus
34
What is granulomatosis with polyangitis
Characterised by a small vessel vasculitis and necrosis, usually limited to the resp tract and kidneys
35
When do patients usually present with granulomatosis with polyangitis
>40
36
Name some ENT features of granulomatosis with polyangitis
Sinusitis, nasal crushing, epistaxis, mouth ulcers, sensorineural deafness, otitis media, subglottic inflammation
37
Investigation for granulomatosis with polyangitis
cANCA positive
38
What is ANCA
Cytoplasmic Anti-neutrophil cytoplasmic antibodies
39
Management of granulomatosis with polyangitis
IV steroids and cyclophosphamide
40
Name the most common benign lesion of the nose
Squamous cell papilloma
41
Name 4 benign lesions of the nose
Squamous cell papilloma Sinonasal papillomas Recurrent respiratory papillomatosis Angiofibroma
42
Who tends to get sinonasal papillomas
Men over 50
43
Clinical presentation of sinonasal papilloma
Blocked nose
44
What is recurrent respiratory papillomatosis
Papilloma form along the aerodigestive tract
45
What is recurrent respiratory papillomatosis associated with
HPV
46
How does recurrent respiratory papillomatosis present
In children with hoarse voice and progressive SOB
47
What is the most common malignant lesion of the nose
Squamous cell carcinoma
48
Where is nasopharyngeal carcinoma usually seen geographically
Far east and parts of Africa
49
Which gender has a higher incidence of nasopharyngeal carcinoma
Males
50
What does nasopharyngeal carcinoma have a strong association with
EBV, volatile nitrosamines in food
51
Name 2 EBV genes which affect normal signalling pathways and how they do it
LMP-1 acts as an oncogene EBNA-2 promotes transition from G0 to G1
52
What is subglottic stenosis
Narrowing of the airway below the vocal chords and above the trachea
53
Most common cause of subglottic stenosis
Idiopathic
54
What has subglottic stenosis been associated with in adults
Vasculitis
55
Clinical presentation of subglottic stenosis
Progressive difficulty breathing made worse by exertion
56
Management of subglottic stenosis
Division of the stenosis If recurrent: resection and reconstruction

otolaryngology (18 decks)

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