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Head and Neck > Rhinology > Flashcards

Rhinology Flashcards

1
Q

How might patient present to Rhinology ?

A 
Nasal obstruction 
Nasal discharge
Facial pain
Epistaxis 
Loss of smell 
Sneezing 
Nasal deformity
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2
Q

What imaging technique can be used to look inside the nose ?

A

Nasal endoscopy

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3
Q

Which blood tests are done ?

A

FBC, RAST, ACE, ANCA

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4
Q

Which other imaging techniques are used to image the nose ?

A

CT/MRI

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5
Q

What is rhinomanometry ?

A

A technique used to measure the pressure within the nasal cavity

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6
Q

What other tests can be done to detect allergies ?

A

Skin tests and RAST blood test

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7
Q

What is the treatment for nasal polyps ?

A

Oral/nasal steroids and immunotherapy
Polypectomy
Endoscopic sinus surgery and microdebridement

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8
Q

Deine Hallitosis

A

Bad breath

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9
Q

Define acute sinusitis

A

< 12 weeks duration and symptoms resolve completely

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10
Q

Define recurrent acute sinusitis

A

> 1 to <4 episodes per year, symptom free period >8 weeks between attacks

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11
Q

Define chronic sinusitis

A

> 12 week duration no symptom free periods. Inflammatory changes seen after 4 weeks after starting therapy

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12
Q

Which bacteria usually cause sinusitis ? (2)

A

H. influenza and S.pneumoniae

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13
Q

Which antibiotic is used to treat S.pneumoniae ?

A

Penicillin

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14
Q

Which antibiotic is used to treat H.influenza ?

A

Clarithromycin

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15
Q

How is sinusitis managed ?

A 
Steroidal nasal spray 
Saline solution 
Antihistmines
Analgesics 
Steam therapy
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16
Q

What are the most common causes of epistaxis ?

A

Trauma
Idiopathic
Drug induced

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17
Q

How is epistaxis managed ?

A

ABC
IV fluids
Blood transufsion
Endoscopy

18
Q

What is done if bleeding cannot be controlled from nose ?

A

Packing

Endoscopic ligation

19
Q

What is Hereditary haemorrhagic telangiectasia (HHT) ?

A

Its a genetic disorder in which people have blood vessels which haven’t developed properly and cause bleeding, known as arteriovenous malformations (AVMs).

20
Q

How is HHT treated ?

A

Laser coagulation
Iron supplements
Septodermoplasty - skin graft
Young’s procedure - flap closure

21
Q

What is an angiofibroma ?

A

A vascular neoplasm of the nasopharynx that can cause obstruction and bleeding

22
Q

How is angiofibroma treated ?

A

Surgery and preoperative embolisation

23
Q

If there is hearing loss and epistaxis what do you need to think ?

A

Cancer

24
Q

Define allergy

A

An immune system response to a foreign substance that not typically harmful to the body

25
Q

What are the risk factors for allergies ?

A 
Genetic
Age 
Race 
Enviromental factors - Childhood infections, exposure to allergens and pollution. 
Dietary changes 
Occupational exposure - Flour and latex
26
Q

How does allergy in the skin present ?

A

As a rash (urticaria) and angio-oedema

27
Q

How does allergy in the URT present ?

A

Rhinitis

28
Q

How does allergy in the LRT present ?

A

Asthma

29
Q

How does allergy present systemically ?

A

Anaphylaxis

30
Q

Define allergen

A

An antigen that causes an allergic reaction

31
Q

What type of hypersensitivity reaction is allergy ?

A

Type 1

32
Q

What antibody is produced ?

A

IgE

33
Q

What does IgE do ?

A

Binds to mast cells when it detects antigen and causes them to release histamines, leukotrienes and prostaglandins

34
Q

What happens acutely when histamines and other inflammatory mediators are released ?

A

Vascular dilation and permeability
Smooth muscle contrasts
WBC infiltrate

35
Q

What happens after a few hours when histamines and other inflammatory mediators are released ?

A

Macrophages and neutrophils migrate to the area

36
Q

How is allergic rhinitis classified ?

A

ARIA

Mild - No impairment on daily activities, no sleep disturbance
Moderate/Severe - Sleep disturbance and troublesome symptoms, impairment of daily activities

37
Q

What is intermittent defined as ?

A

<4 days per weeks for < 4 consecutive weeks

38
Q

What is persistent defined as

A

> 4 days per week and > 4 consecutive weeks

39
Q

What is found on skin tests in those with allergic rhinitis ?

A

High IgE NPV

40
Q

What other tests can be done to test for allergies ?

A

Nasal allergen challenge
Nasal cytology
Total serum IgE

Head and Neck (6 decks)

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