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Flashcards in Sinusitis Deck (11):
1

Define acute rhinosinusitis

1. Rapid onset inflammation of nose and paranasal sinuses +
Nasal blockage or nasal discharge
Facial pain or pressure
Reduction/loss of smell

2

Commonest cause of acute rhinosinusitis

1. Viral

3

When can bacterial occur

Usually as result of viral
immunocompromised
Odontogenic infection
Deficient mucociliary clearance
Mechanical nasal obstruction

Usually S pneumoniae
Severe fungal in immunocompromised/diabetic

4

Management of uncomplicated acute viral rhinosinusitis

1. Usually for 7-10 days
2. Adequate and regular simple analgesia
3. Saline nasal sprays
4. Topical nasal corticosteroids
5. Decongestants->do not use for longer than three days
6. Topical ipratropium bromide may lessen rhinorrhea

5

When to consider antibiotics

1. Symptoms >7 days, purulent discharge, sinus tenderness, maxillary toothache
2. Severe symptoms and high fever >39 at onset and lasting>3 days
3. Worsening after initial improvement

6

Antibiotics used

Amoxycillin 500mg, 15mg/kg PO 8 hourly for 5 days
If inadequate
Amoxycillin + clavulanate

7

What is chronic sinusitis, contributing

Symptoms lasting >12 weeks
Bacterial infection
Allergy
CF
Physical obstruction
Swelling for another reason
Mucocillary impairment
Immune deficiency
Prolonged use of decongestants

8

On inspection of nose, in chronic rhinosinusitis what may be found

Nasal polyps

9

Treatment in chronic rhinosinusitis

Prednisilone: tapering dose over three weeks if polyps, for 5-10 days if without polyps

10

Should NSAIDs be used in chronic with nasal polyps

Risk of sensitivity, also in asthma

11

DDX of sore throat

1. Strep pharyngitis
2. Viral pharyngitis
3. Infectious mononucleosis
4. Tonsilitis
5. Peritonsillar abscess
6. Foreign body/trauma
7. Leukemia
8. Hodgkins disease