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Flashcards in sinuses and thorat Deck (46):
1

what is recurrent acute rhinosinusitis (RARS)

4 or more recurrent episodes annually

2

what does our body do so that one nasal airway doesn't dry more than the other

makes turbinates asymmetrically thick at varying times

3

when do you drain the maxillary sinuses?

when you lay down

4

what is the most common cause of rhinosinusitis?

allergic rhinitis

5

what sinuses are more affected in children?

ethmoid

6

what sinuses become blocked in adults?

maxillary or frontal

7

complications of untreated rhinosinusitis

osteomyelitis, orbital cellulitis, cavernous sinus thrombophlebitis, intracranial suppuration

8

most common location for retinal detachment

superior temporal region

9

how long is chronic sinusitis

over 12 weeks

10

what are indications for endoscopic sinus surgery

symptoms of CRS and recurrent acute rhinosinusitis

11

what should be done before sinus surgery

Coronal CT scan
MRI is good for erosion of the orbital bone
allergy testing
eosinophil counts

12

Ideal for patients who fail medical therapy but do not want or are unable to have sinus surgery.
Conservative approach that preserves future treatment options

balloon treatments

13

hereditary hemorrhagic dz associated with Telangiectasias of lips, nasal mucosa, tongue

Osler-Weber-Rendu (hereditary hemorrhagic)

14

what are some bleeding disorders than can cause epistaxis

idiopathic thrombocytopenia purpura
von Willebrand's disease
Hemophilia

15

Often bilateral bleeding or down into oropharynx. Brisk arterial bleeding.. More common in older adults.

posterior nose bleed

16

tx for anterior epistaxis

cocaine
lidocaine
silver ntirate cautery
surgicel and packing

17

tx for posterior epistaxis

Vasoconstriction with cocaine solution or oxymetazoline
Cautery, tamponade, pack, arterial embolization

18

caused by overuse of nasal decongestants

Rhinitis medicamentosa

19

what drugs are associated with rhinitis?

ACEI, beta blockers
NSAIDS

20

what is the 2nd option if a patient doesn't respond well to an antihistamine?

nasal corticosteroid

21

what is more effective- antihistamine or nasal corticosteroid

nasal corticosteroid

22

where should you aim the nasal corticosteroid towards?

The ear on that side (outward) better distribution

23

with significant nasal polyposis or severe symptoms what can you do?

short courses with prednisone

24

what is good for exercise and gustatory rhinitis

intranasal cromolyn

25

if a person has allergic rhinitis and has failed intranasal corticosteroids

ipratropium bromide

26

what are non-infectious causes of pharyngitis

chronic sinus drainage
GERD

27

Tx for Peritonsillar abscess

I and D (best choice) or high dose abx

28

Viral causes of infectious pharyngitis

Adenovirus, parainfluenza, rhinovirus
Epstein-Barr

29

(herpangina) with tonsillar pillar/soft palate vesicles/ulcers

Coxsackie A

30

is presence of exudates diagnostic for GAS pharyngitis?

No, can be other causes

31

what is the most common cause of pharyngitis?

S. pyogenes

32

Pseudomembrane (whitish, blue) on back of throat

Corynebacterium diphtheriae

33

Tx for GABHS?

amoxicilin

34

main reason for false negative on rapid strep antigen test

eat within 15 minutes
shouldn't eat for about an hour before

35

what is the Centor criteria for strep?

tonsillar exudate
tender anterior cervical LAD
hx of fever
absence of cough
(need at least 3 of 4 present)

36

if a person has 2 or more of the centor criteria what should you do?

rapid strep , only treat positives

37

how are vocal cord nodule seen?

symmetrical

38

if you see the false and normal vocal cords vibrating what do you dx them with?

vocal cord dysfunction, send to speech therapy

39

77 year old male with 60 pack year history, GERD, and new onset hoarseness, what is at the top of your list?

Cancer

40

15 year old cheerleader with GERD has new onset onset hoarseness what do you suspect?

overuse and combo of GERD

41

45 y/o man, leader in church, 2 weeks ago and was unable to speak. Had been losing voice intermittently and has anxiety. Deviated nasal septum, elongated soft palate and uvula.

allergic rhinitis

42

tx for turbinate hypertrophy

tubinoplasty

43

what association should you make with turbinate hypertophy

allergic rhinitis

44

when you take a deep breath and the vocal cords close off

spasmodic dysphonia

45

tx for laryngospasm (spasmodic dysphonia)

speech therapy, help prevent spasm of vocal folds

46

what is laryngospasm associated with

anxiety