Rhinosinusitis - epistaxis - DVT/PE

Question 1

epistaxis

Answer 1

nose bleeding

Question 2

epistaxis - MC occurs in (area)

Answer 2

anterior segment of nostril (KIESSELBACH PLEXUS)

Question 3

epistaxis - life threatening

Answer 3

life threatening haemorrhages occurs in posterior segment of nostril (sphenopalatine artery, a branch of maxillary artery)

Question 4

posterior segment of nostril epistaxis

Answer 4

life threatening hemorrhages (sphenopalatine artery, a branch of maxillary artery)

Question 5

Rhinosinusitis pathophysiology

Answer 5

obstruction of sinus drainage into nasal cavity –> inflammation and pain over affected area

Question 6

Rhinosinusitis symptoms

Answer 6

1. pain over affected area

2. Maybe loss of smell

Question 7

MC acute cause of Rhinosinusitis

Answer 7

viral URI

Question 8

Rhinosinusitis MAY CAUSE

Answer 8

superimposed bacterial infection, most commonly by

a. S. pneumonia
b. H. influenza
c. M catarrhalis

Question 9

Typical area for Rhinosinusitis

Answer 9

maxillary sinuses, which drain into middle meatus, in adults

Question 10

Rhinosinusitis - what may show in CT

Answer 10

nasal septal deviation

Question 11

deep venous thrombosis - definition

Answer 11

blood clot within a deep vein

Question 12

deep venous thrombosis - symptoms

Answer 12

1. swelling
2. redness
3. warmth
4. pain

Question 13

deep venous thrombosis is predisposed by

Answer 13

Virchow triad

1. stasis
2. hypercoagulability
3. Endothelial damage

Question 14

virchow triad - endothelial damage

Answer 14

exposed collagen triggers clotting cascade

Question 15

virchow triad - hypercoagulability

Answer 15

defect in coagulation cascade proteins, such as factor V Leiden

Question 16

Homan sign

Answer 16

DVT

dorsiflexion of foot –> calf pain

Question 17

most of pulmonary emboli arise from ….

proportion?

Answer 17

proximal deep veins of lower extremity

95%

Question 18

prophylaxis and acute management of DVT

Answer 18

unfractionated heparin
OR
low molecular weight heparin

Question 19

treatment (long time prevention) of DVT

Answer 19

oral anticoagulants (e.g. warfarin, rivaroxaban)

Question 20

imaging study for pulmonary emboli

look for

Answer 20

CT pulmonary angiography

look for filling defects

Question 21

Pulmonary emboli - CT pulmonary angiography

look for

Answer 21

filling defects

Question 22

types/causes of pulmonary emboli

Answer 22

mnemomic: FAT BAT

1. Fat 2. Air 3. Thrombus 4. Bacteria 5. Amnionionic fluid 6. Tumor

Question 23

pulmonary emboli symptoms

Answer 23

1. sudden onset of dyspnea
2. chest pain
3. tachypnea
4. tachycardia
5. SUDDEN DEATH

Question 24

air emboli pathophysiology

Answer 24

nitrogen bubbles precipitate in ascending divers (caison disease, decompression sickness)

Question 25

air emboli treatment

Answer 25

hyperbaric O2

Question 26

fat emboli - situations

Answer 26

1. long bone fractures | 2. liposuction

Question 27

fat emboli - symptoms

Answer 27

classic triad: 1. hypoxemia 2. neurologic abnormalities 3. petechial rash

Question 28

thrombi pulmonary emboli - histology

Answer 28

lines of Zahn: interdigitating areas of pink (platelets, fibrin) and red (RBCs) found only in thrombi formed before death

Question 29

lines of Zahn: pink areas

Answer 29

platelets and fibrin

Question 30

lines of Zahn: red areas

Answer 30

RBCs

Question 31

lines of Zahn - utility

Answer 31

help distinguish pre and postmortem thrombi

Question 32

Pulmonary embolism - ph (mechanism)

Answer 32

V/Q mismatch --> hypoxemia --> respir alkalosis

Question 33

Amnionic fluid emboli can lead to (according to Lungs)

Answer 33

DIC, especially postpartum

Question 34

tumor that causes DVT

Answer 34

glucagonoma

Question 35

glucagonoma symptoms

Answer 35

1. dermatitis (necrolytic migratory erythema) 2. diabetes (hyperglycemia) 3. DVT 4. Depression

Question 36

Head and neck cancer - type

Answer 36

mostly SCC

Question 37

Head and neck cancer - risk factors

Answer 37

1. tobacco 2. alcohol 3. HPV-16 (oropharyngeal) 4. EBV (nasopharyngeal

Question 38

Head and neck cancer - HPV-16 vs EBV

Answer 38

HPV-16 --> oropharyngeal | EBV --> nasopharyngeal

Question 39

Head and neck cancer - filed cancerization

Answer 39

carcinogens gamage wide mucosal area --> multiple tumors