Flashcards in sinuses and thorat Deck (46):
what is recurrent acute rhinosinusitis (RARS)
4 or more recurrent episodes annually
what does our body do so that one nasal airway doesn't dry more than the other
makes turbinates asymmetrically thick at varying times
when do you drain the maxillary sinuses?
when you lay down
what is the most common cause of rhinosinusitis?
what sinuses are more affected in children?
what sinuses become blocked in adults?
maxillary or frontal
complications of untreated rhinosinusitis
osteomyelitis, orbital cellulitis, cavernous sinus thrombophlebitis, intracranial suppuration
most common location for retinal detachment
superior temporal region
how long is chronic sinusitis
over 12 weeks
what are indications for endoscopic sinus surgery
symptoms of CRS and recurrent acute rhinosinusitis
what should be done before sinus surgery
Coronal CT scan
MRI is good for erosion of the orbital bone
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
hereditary hemorrhagic dz associated with Telangiectasias of lips, nasal mucosa, tongue
Osler-Weber-Rendu (hereditary hemorrhagic)
what are some bleeding disorders than can cause epistaxis
idiopathic thrombocytopenia purpura
von Willebrand's disease
Often bilateral bleeding or down into oropharynx. Brisk arterial bleeding.. More common in older adults.
posterior nose bleed
tx for anterior epistaxis
silver ntirate cautery
surgicel and packing
tx for posterior epistaxis
Vasoconstriction with cocaine solution or oxymetazoline
Cautery, tamponade, pack, arterial embolization
caused by overuse of nasal decongestants
what drugs are associated with rhinitis?
ACEI, beta blockers
what is the 2nd option if a patient doesn't respond well to an antihistamine?
what is more effective- antihistamine or nasal corticosteroid
where should you aim the nasal corticosteroid towards?
The ear on that side (outward) better distribution
with significant nasal polyposis or severe symptoms what can you do?
short courses with prednisone
what is good for exercise and gustatory rhinitis
if a person has allergic rhinitis and has failed intranasal corticosteroids
what are non-infectious causes of pharyngitis
chronic sinus drainage
Tx for Peritonsillar abscess
I and D (best choice) or high dose abx
Viral causes of infectious pharyngitis
Adenovirus, parainfluenza, rhinovirus
(herpangina) with tonsillar pillar/soft palate vesicles/ulcers
is presence of exudates diagnostic for GAS pharyngitis?
No, can be other causes
what is the most common cause of pharyngitis?
Pseudomembrane (whitish, blue) on back of throat
Tx for GABHS?
main reason for false negative on rapid strep antigen test
eat within 15 minutes
shouldn't eat for about an hour before
what is the Centor criteria for strep?
tender anterior cervical LAD
hx of fever
absence of cough
(need at least 3 of 4 present)
if a person has 2 or more of the centor criteria what should you do?
rapid strep , only treat positives
how are vocal cord nodule seen?
if you see the false and normal vocal cords vibrating what do you dx them with?
vocal cord dysfunction, send to speech therapy
77 year old male with 60 pack year history, GERD, and new onset hoarseness, what is at the top of your list?
15 year old cheerleader with GERD has new onset onset hoarseness what do you suspect?
overuse and combo of GERD
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.
tx for turbinate hypertrophy
what association should you make with turbinate hypertophy
when you take a deep breath and the vocal cords close off
tx for laryngospasm (spasmodic dysphonia)
speech therapy, help prevent spasm of vocal folds