Rhinosinusitis and nasal polyps

Question 1

definition rhinosinusitis

Answer 1

inflammation in nose and paranasal sinuses with >2 symptoms one of which is nasal congestion or discharge

Question 2

symptoms rhinosinusitis

Answer 2

facial pain, decr olfaction, polyps, pus

Question 3

when is the rhinosinusitis chronic

Answer 3

> 12 weeks

Question 4

treatment rhinosinusitis

Answer 4

topical corticosteroids and oral antibiotics

Question 5

causes of nasal congestion in children

Answer 5

adenoids, rhinitis, postnasal space tumour, FB

Question 6

causes of nasal congestion in adults

Answer 6

deflected nasal septum, granuloma, tricyclics, vasoconstrictors

Question 7

when should you refer urgently

Answer 7

numb, tooth loss, bleeding, unilateral obstructing mass. may be a tumour

Question 8

what is allergic rhinosinusitis mediated by

Answer 8

IgE

Question 9

what antihistamines can be used in allergic rhino

Answer 9

loratadine, nasal steroids- beclometasone

Question 10

causes of chronic rhinorrhoea, rhinitis

Answer 10

allergies, FB, CSF, bacteria, HIV, CF, RA, age, pregnancy, the pill, B blockers

Question 11

typical nasal polyp patient

Answer 11

male >40

Question 12

sites of nasal polyps

Answer 12

middle turbinates, middle meatus, ethmoids

Question 13

when would you be worried in nasal polyps

Answer 13

unilateral polyp and epistaxis- could be a sign of nasopharyngeal cancer, glioma, lymphoma, sarcoma)

Question 14

symptoms nasal polyp

Answer 14

watery rhinorrhoea, postnasal drip, obstruction, change in voice, anosmia, sinusitis, headache, snoring, pain

Question 15

sign nasal polyp

Answer 15

pale, mobile, insensitive to gentle palpation

Question 16

what can you use in nasal polyps

Answer 16

betamethasone drops for 48h, beclomethasone spray- maintenance, prednisolone, endoscopic polypectomy

Question 17

what are polyps associated with

Answer 17

allergic rhinitis, non allergic rhinitis, chronic ethmoid sinusitis, CF, aspirin hypersensitivity, asthma

Question 18

if a polyp is found in a child what needs to be excluded

Answer 18

neoplasms, CF, meningocele/encephalocele

Question 19

symptoms sinusitis

Answer 19

pain, discharge, nasal obstruction, anosmia, systemic symptoms

Question 20

causes bacterial sinusitis

Answer 20

most follow viral infection, direct spread, anatomy (deviation, polyps), ITU, systemic causes

Question 21

treatment sinusitis

Answer 21

most self limiting- nasal douching and topial steroids/decongestants. antibiotics- amoxicilin

Question 22

chronic/recurrent sinusitis

Answer 22

functional endoscopic sinus surgery. fluticasone

Question 23

complications sinusitis

Answer 23

mucocoeles may become infected, orbital cellulitis/abscess, osteomyelitis, intracranial infection