Rhinology

Question 1

What should you do if you come across nasal trauma soon after the incident

Answer 1

Try reduce the fracture by manipulating the nose

Question 2

What can be done to a nasal trauma if seen months after the incident

Answer 2

Rhinoplasty

Question 3

What is Rhinoplasty

Answer 3

Surgery to change the shape of the nose

Question 4

What are some complications of nasal trauma

Answer 4

Nasal blockage
Septal Haematoma
Possibly septal Abscess

Question 5

What is treatment for a septal haematoma

Answer 5

Drain and pack nose

Question 6

Is the treatment for a septal haematoma an emergency

Answer 6

Yes

Question 7

Why is a septal haematoma an emergency

Answer 7

If not treated then septal perforation can occur due to necrosis of tissue

Question 8

What is Rhinits

Answer 8

Inflammation and swelling of the mucous membranes of the nose

Question 9

What more commonly causes rhinitis : Viral or Bacterial

Answer 9

Viral

Question 10

What is treatment for viral rhinitis

Answer 10

Just relieve symptoms

Question 11

What bacteria could cause bacterial rhinitis

Answer 11

S.Pneuamonia

H. Influenzae

Question 12

What is treatment for bacterial rhinitis

Answer 12

Antibiotics:

B lactams - Penicillin/cephalosporins
Macrolides - erythromycin/clarithromycin

Question 13

What categories can the causes of rhinitis be put into

Answer 13

Allergic and non allergic

Question 14

When does acute rhinitis progress to chronic rhinitis

Answer 14

If you have 2 or more of the following symptoms for 12 weeks

• Nasal obstruction
• Nasal drainage
• Facial pain/pressure
• Hyposmia/Anosmia

Question 15

What other condition does chronic rhinitis usually cause

Answer 15

Sinusitis

Question 16

When does chronic rhinitis/sinusitus become an emergency

Answer 16

If it progresses to something more serious

• Acute periorbital swelling
• Fever
• Frontal headache
• Potts Puffy tumour
• Ethmoid Mucocelle

Question 17

What is treatment for emergency sinusitis/rhinitis

Answer 17

Get opthalmic opinion
Urgent CT
IV antibiotics
Emergency surgery

Question 18

What is Potts Puffy tumour

Answer 18

Pott puffy tumor is osteomyelitis of the frontal bone with associated subperiosteal abscess causing swelling and edema over the forehead and scalp. It is a complication of frontal sinusitis or trauma.

Question 19

What is Ethmoid mucocele

Answer 19

An ethmoid mucocele is a form of a paranasal sinus mucocele involving the ethmoid air cells.

Question 20

What are painless growths inside the nose called

Answer 20

Nasal polyps

Question 21

What is the cause of nasal polyps

Answer 21

Unknown

Question 22

What are nasal polyps typically secondary to

Answer 22

Cystic fibrosis
Allergic fungal sinusitis
Churg-Strauss Syndrome

Question 23

What is Churg-Strauss syndrome

Answer 23

Churg-Strauss syndrome is a disorder marked by blood vessel inflammation. This inflammation can restrict blood flow to organs and tissues, sometimes permanently damaging them. This condition is also known as eosinophilic granulomatosis with polyangiitis (EGPA). Asthma is the most common sign of Churg-Strauss syndrome.

Question 24

What are investigations for Nasal polyps

Answer 24

Sweat test
Skin test
Nasal Smear

Question 25

What is the treatment for Nasal Polyps

Answer 25

Oral and nasal steroids Immunotherapy Polypectomy

Question 26

What is samtars triad

Answer 26

Samter's Triad is a condition in which an individual has asthma, sinus inflammation with recurring nasal polyps, and sensitivity to aspirin and some other NSAIDs.

Question 27

What happens when someone with samtars triad is given aspirin

Answer 27

When aspirin or a similar drug is taken, people with Samter's Triad have a severe reaction with both upper and lower respiratory symptoms.

Question 28

What is the treatment for people with samtars triad

Answer 28

Give tiny amounts of aspirin over time to help the body build up resistance

Question 29

What is Epistaxis

Answer 29

Nose Bleeds

Question 30

What are local causes of epistaxis

Answer 30

- Trauma, - Inflammation, - Topical drugs (such as corticosteroids), - Surgery, - Vascular causes (hereditary haemorrhagic telangiectasia and Wegener's granulomatosis), - Tumours (such as squamous cell carcinoma).

Question 31

What are general causes of epistaxis

Answer 31

- Hypertension - Atherosclerosis, - Increased venous pressure from mitral stenosis, -Haematological disorders (such as thrombocytopenia, leukaemia, and haemophilia), - Environmental factors (such as temperature, humidity, or altitude), - Systemic drugs (such as anticoagulants and antiplatelets), - Excessive alcohol consumption.

Question 32

What is the immediate treatment for Epistaxis

Answer 32

First aid - Hold soft part of nose and tip head forward. Open mouth. Stay for 15 mins

Question 33

If admitted to hospital and first aid measures have not stopped bleeding what should be done next

Answer 33

Use suction and adrenaline soaked cotton wool to clear blood and attempt to find bleeding point.

Question 34

Is an anterior nose bleed likely to be from one nostril or both

Answer 34

One

Question 35

Is a posterior nose bleed likely to be from one nostril or both

Answer 35

Both

Question 36

What should be done if a posterior nose bleed is suspected

Answer 36

If a posterior bleed is suspected (bleeding is profuse, from both nostrils, and the bleeding site cannot be identified on examination), admission to hospital is recommended.

Question 37

If bleeding stops due to first aid methods what treatment can then be supplied

Answer 37

Naseptin® (chlorhexidine and neomycin) cream may be applied to prevent re-bleeding.

Question 38

What is a contraindication to naseptin

Answer 38

Peanut allergies

Question 39

If epistaxis is refusing to stop after first aid and a bleeding point has been identified what should then next line of treatment be

Answer 39

Cauterise with silver nitrate stick

Question 40

When should you not cauterise an Epistaxis (x3)

Answer 40

If the bleed is from a large area If the bleed is from both sides of the nose If the person has already been cauterised often

Question 41

If epistaxis is refusing to stop after first aid and NO bleeding point has been identified what should then next line of treatment be

Answer 41

Nasal packing with either - Inflatable rapid rhino - Nasal tampon

Question 42

What type of tumour can be found in the nose

Answer 42

Angiofibroma

Question 43

What are the symptoms of a nasal tumour

Answer 43

Long lasting blocked nose Frequent epistaxis Reduced sense of smell Sometimes causes hearing loss

Question 44

Are nasal tumours common

Answer 44

No - they are rare

Question 45

What is the treatment for a nasal tumour

Answer 45

Surgery

Question 46

What are the subtypes of non allergic rhinitis

Answer 46

``` Vasomotor Infectious Hormonally induced Gustatory Granulomatous Drug induced ```

Question 47

What triggers vasomotor rhinitis

Answer 47

irritants (perfumes, chlorine, cold air)

Question 48

What are characteristics of hormonally induced rhintis

Answer 48

Non-allergic rhinitis associated with pregnancy or mentrual cycle

Question 49

What is Gustatory rhinitis

Answer 49

Rhinitis associated with eating