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Clinical Med B > nose triggers > Flashcards

nose triggers Flashcards

1
Q

can be caused by:
Viral URI (MC)
Allergic rhinitis
NG tube
dental infections

A

acute bacterial sinusitis

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2
Q

what sinus is affected w pain on the vertex of the head

A

sphenoid

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3
Q

pain with palpation just below medial portion of eyebrows is likely which sinus

A

frontal

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4
Q

unilateral face pressure and tenderness with pain referred to incisor or canine teeth

A

maxillary sinus pain

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5
Q

tx with augmentin is seen in which diagnoses

A
  • acute bacterial rhinosinusitis
  • chronic sinusitis
  • epistaxis to prophylactically tx toxic shock
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6
Q

tx w augmentin.
if anaphylaxis to PCN use doxy, levo, moxi or azithro

A

acute bacterial rhinosinusitis

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7
Q

tx with augmentin, if non-severe PCN allergy use cinda + cefixime or cefpodoxime.

A

acute bacterial rhinosinusitis

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8
Q

intranasal corticosteroids

A

acute bacterial rhinosinusitis
chronic sinusitis
mod-severe allergic rhinitis

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9
Q

black eschar on middle turbinate

A

invasive fungal sinusitis

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10
Q

CN V and VII involvement in severe cases

A

invasive fungal sinusitis

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11
Q

long standing unilateral symptoms, non-specific mucosal changes on CT with opacification of a single sinus

A

Mycetoma (chronic fungal sinusitis)

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12
Q

biopsy from nasal endoscopy and CT to determine extent of disease

A

Chronic fungal sinusitis

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13
Q

treated with IC amphotericin B then after 3-6 months switch to itraconazole

A

chronic fungal sinusitis

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14
Q

risk factors include hx of nasal polyposis, asthma, and sinus surgeries

A

allergic fungal sinusitis

also caused by:
high levels of IgE in body
fungus allergy

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15
Q

endoscopic sinus surgery to remove debris followed by 3 months of systemic steroids

A

allergic fungal sinusitis

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16
Q

causes inflammation of the blood vessels

A

wegener’s ganulomatosis

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17
Q

symptoms include joint aches, blood in urine, cough, fever, hearing loss and sinus pain

A

Wegener’s granulomatosis

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18
Q

saddle-nose deformity

A

wegener’s granulomatosis

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19
Q

purulent bloody discharge, nasal crusting, smell disturbances, sinus pain

A

wegener’s granulomatosis d/t blood flow reduced to nose

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20
Q

diagnostics include PFT, CT sinus, CXR, rheumatology workup and a biopsy

A

wegener’s granulomatosis

21
Q

treated with steroids and immunosuppressants

A

wegener’s granulomatosis

22
Q

cobblestoning of pharynx

A

allergic rhinitis

23
Q

nasal mucosa that is pale, bluish hue and boggy d/t venous engorgement

A

allergic rhinitis

24
Q

what could increase obstructive symptoms in allergic rhinitis

A

nasal polyps

25
Q

nasal secretion biopsy
serum IgE level

A

Allergic rhinitis diagnostics
also allergy skin testing

Nasal secretion will show EOSINOPHILS

26
Q

which testing requires refrainment form antihistamines

A

skin allergy test

NOT teh IgE one!

27
Q

when are antihistamines preferred

A

2ng gen antihistamines used in mild intermittent allergic rhinitis

28
Q

nasal irrigation
intranasal steroids
augmentin

A

chronic sinusitis

29
Q

2nd gen antihistamines

A

all end in dine or zine

Cetirizine (Zyrtec)
Loratadine (Claritin)
Fexofenadine (Allegra)
Desloratadine (Clarinex)
Levocetirizine (Xyzal)

30
Q

nasal antihistamines

A

azelastine
olopatadine

31
Q

avoid in narrow angle glaucoma, CVD, CAD, HTN hypothyroidism and urinary retention

A

sudafed

32
Q

has risks of rebound vasodilation and rhinitis medicamentosa

A

phenylephrine/oxymetazoline

33
Q

Insomnia, tremor, tachycardia, HTN are all common side effects of what

A

decongestants (sudafed or phenylephrine/oxymetazoline)

34
Q

combo drugs for allergic rhinitis

A

claritin D and allegra D

antihistamine + sudafed

35
Q

Neuropsychiatric changes such as dreams, insomnia, anxiety, depression, suicidal thinking

A

montelukast SE

36
Q

what are the leukotriene antagonists

A

leukotrienes, montelukast,

37
Q

what is the anticholinergic used in allergic rhinitis

A

ipratropium bromide
usually combined with intranasal steroids

38
Q

CI in CVD, uncontrolled asthma, BB use

A

allergy shots.
only for severe allergic rhinitis

39
Q

what is the MOA of the allergy shots

A

slowly introduce small amounts of allergins into the tissues and over the course of 3-5 years desensitize the patient to allergens

40
Q

bilateral nose bleed

A

posterior epistaxis

41
Q

kiesselbacks plexus

A

MC area of anterior epistaxis

42
Q

silver nitrate or lidocaine + epi

A

anterior epistaxis.

can also use nasal packing or cocaine

43
Q

narcotic analgesics

A

posterior epistaxis

44
Q

ligation of nasal arterial supply

A

posterior epistaxis

45
Q

augmentin, clinda and keflex used for…

A

ABX prophylaxis in nasal packing for toxic shock syndrome

46
Q

Pale, edematous, mucosally covered masses.

A

nasal polyps

47
Q

indicative of cystic fibrosis when found in children

A

nasal polyps

48
Q

topical nasal steroids 1-3 months followed by oral steroids. if no change surgery is indicated

A

nasal polyps

49
Q

presents with persisten unilateral epistaxis and foul smelling, copious rhinorrhea

A

nasal foreign body

Clinical Med B (22 decks)

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