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Flashcards in Sinus Deck (52):
1

What is the definition of rhinosinusitis?

Inflammation of the nose and the sinuses

2

What are the s/sx of rhinosinusitis? (4)

-facial pain
-hyposmia
-Fever
-Nasal obstruction

3

What is the timeframe for acute rhinosinusitis?

Up to 4 weeks

4

What is the timeframe for subacute rhinosinusitis? Chronic?

4-12 weeks
12+ weeks = chronic

5

What is the definition of recurrent acute rhinosinusitis?

4 or more episodes / year

6

True or false: sinusitis typically precedes rhinitis

False--other way around

7

True or false: sinusitis without rhinitis is rare

True

8

The mucus membrane of the nose is continuous down to what part of the respiratory pathway?

Tracheobronchial tree

9

What are the classic s/sx of rhinitis?

-congestion
-Sneezing
-Itching
-Nasal d/c

10

What is the usual cause of rhinitis/sinusitis?

viral etiology with 2/2 bacterial infection a common complication

11

What are the classic signs of rhinitis/ sinusitis?

Discolored nasal containing PMNs

12

What causes the green coloration of mucus?

PMN peroxidase

13

Purulent d/c for more than how many days suggests bacterial rhinitis and/or rhinosinusitis?

5 days

14

True or false: the color of the sputum is indicative of the etiology of rhinitis/sinusitis?

True per him

15

What are the s/sx of rhinosinusitis?

-Nasal obstruction/congestion
-d/c / purulence
-Cough
-HA

16

Which sinus in particular can cause sinus HAs?

Sphenoid sinuses

17

True or false: There has to be hearing loss if there is fluid in the ear

True

18

True or false: fever and/or leukocytosis is often present with chronic rhinosinusitis

False--uncommon

19

What are the associated causes of rhinitis?

Seasonal allergic issues

20

What type of secretions are had with allergic rhinitis?

Watery rhinorrhea
Repetitive sneezing

21

True or false: allergic rhinitis plays a significant role in chronic rhinitis

True

22

What is the classic presentation of a kid with large adenoids?

mouth breathers

23

Chronic adenoiditis mimics what?

Rhinosinusitis and allergies

24

What are the symptoms of adenoiditis?

-Nasal congestion
-Chronic rhinorrhea
-Chronic cough

25

If a kid under four presents with s/sx consistent with sinusitis, what etiology should be suspected?

Adenoids

26

What happens to the adenoids as we age?

Shrink, but not always

27

What is the relationship between adenoids and the incidence of OM?

If take adenoids out, lowers recurrence rate of OM

28

What happens to the drainage with adenoids with abx treatment?

d/c clears, with rapid return of drainage when off of meds

29

True or false: to meet the diagnostic criteria for laryngopharyngeal reflux, kids have to be spitty

False

30

What is the relationship between acid reflux and upper airway disease

Positive correlation

31

What should be thought of in patients who have recurrent mucosal infections?

Immune deficits

32

What are the three major risk factors for the development of upper airway disease in kids?

-Smoking
-daycare
-Allergen exposure

33

What is the chronic lower airway condition that predispose kids to rhinosinusitis?

Asthma

34

What are the chronic upper airway conditions that predispose kids to rhinosinusitis?

-Eustachian tube dysfunction
-Nasal polyposis
-Allergic conjunctivitis

35

What is the role of sinusitis and asthma?

Inflammation in the nose may increase lower airway hyperresponsiveness

36

How do you diagnose sinusitis?

-Type of nasal drainage
-Intranasal and pharyngeal exam

37

What is the role of plain films in diagnosing rhinosinusitis?

No role

38

What is the role of CT scans in diagnosing rhinosinusitis?

For medical failures

39

True or false: WBC is usually normal with chronic sinusitis

True

40

What is the role of MRIs in diagnosing rhinosinusitis?

Overkill

41

What is the treatment for sinusitis?

-Augmentin

42

What is the role of oral steroids in the treatment of sinusitis?

Can help calm down acute inflammation

43

How fast do topical steroids work to treat rhinitis?

not instant, but relatively fast

44

True or false: topical steroids are used only for chronic sinusitis

False--can be used in acute episodes as well

45

What is the treatment of choice for sinusitis 2/2 allergies?

Oral antihistamines and Decongestants

46

What are the two major types of topical decongestants for sinusitis?

Phenylephrine
Oxymetazoline

47

When does rebound vasodilation occur with topical decongestants?

3 days

48

How long does it take for rhinitis medicamentosa to take effect?

10 days - 14 days

49

How severe are the risks of adenoidectomy?

Safe, with minimal pain and no real long term issues

50

What is the medical therapy for adenoiditis?

Prolonged abx or topical steroids

51

What is balloon tech for sinusitis?

Insert into sinus and blow up to dilate the bone

52

What is the role of packing for sinusitis?

No longer done