Stuffy Noses

Question 1

What type of cells are involved in a type 1 hypersensitivity reaction

Answer 1

Mast cell
Histamine
Leukotrienes

Question 2

What types of drugs might we prescribe for a stuffy nose

Answer 2

Topical corticosteroids
anti-histamines
decongestants
Anticholinergics

Question 3

What are the 4 core nasal symptoms

Answer 3

Blockage
Loss of smell
Discharge
Facial pain

Question 4

What are 4 less common nose related symptoms

Answer 4

sneezing
itch
crusting epistaxis

Question 5

What are 5 secondary symptoms to nasal problems

Answer 5

dry mouth 
sore throat 
snoring 
halitosis 
loss of taste

Question 6

What 3 factors are important to consider on examining a nose

Answer 6

Rhinoscopy
Airway patency
External nose

Question 7

What are some cases of rhinitis

Answer 7

Infective - viral URTI

non - infective - allergic or non allergic

Question 8

Describe the normal mucosa of the nose

Answer 8

Pink
not inflamed
no discharge

Question 9

What are some symptoms of allergic conditions

Answer 9

Rubbing nose
Itchy palate
Itchy eyes
Allergic crease on the nose

Question 10

What are 3 intermittent causes of allergic rhinitis

Answer 10

Grass pollen
Tree pollen (spring)
Fungal spores

Question 11

What are 3 peresistent causes of allergic rhinitis

Answer 11

House dust mite
dog
cat

Question 12

What should be prescribed if a patient has sneezing and itching

Answer 12

Antihistamines

Question 13

What should be prescribed if the patient has nose block

Answer 13

topical Steroids

Question 14

What should be prescribed if the patient has an itch and sneezy as well as nasal block

Answer 14

Topical steroids and antihistamine

Question 15

Describe the appearance of bad nasal polyps on a CT scan

Answer 15

No air (black) areas in the sinus as they are completely blocked

Question 16

What are nasal polyps often associated with

Answer 16

Non-allergic asthma

Question 17

How do we trat nasal polyps

Answer 17

Oral then topical steroids

If no better then surgery

Question 18

What are the 3 main features of acute infective rhino sinusitis

Answer 18

Facial pain
discharge
nasal blockage

Question 19

How can we treat acute infective rhinosinusitis

Answer 19

analgesics and decongestants

if persisting / worsening - antibiotic

Question 20

What can ethmoid cells infection cause

Answer 20

An infection affecting the orbit due to the location of the optic nerve

Question 21

What happens with a pericellular orbit

Answer 21

Pus within the orbit - medical emergency that requires surgical drainage
High rate of blindness that could result in death

Question 22

What age of patients are at risk of developing pericellular orbit

Answer 22

18/19 year old males or children

Question 23

What is the main symptom for vasomotor rhinitis

Answer 23

Nasal drip in the elderly

Question 24

What is the treatment for vasomotor rhinitis

Answer 24

Ipaitropium

Question 25

What is the most common diagnosis of infective rhinitis

Answer 25

Rhinosinusitis

Question 26

What 2 investigations should not be carried out in rhinitis

Answer 26

Nasal X ray or sinus X ray

Question 27

What investigations should be carried out for rhinitis

Answer 27

Skin prick test | RAST (IgE levels)

Question 28

What is the management of non-infective rhinitis

Answer 28

Allergen/ irritant avoidance House dust mite Change drug therapy (antihypertensives can cause non-infective rhinitis) Lower alcohol intake

Question 29

What can be prescribed for non-infective rhinitis

Answer 29

Topical nasal steroids Antihistamine if appropriate Topical anticholinergic - for vasomotor rhinitis

Question 30

What is the management for infective rhino sinusitis

Answer 30

Nasal decongestant Analgesia ? Broad spectrum antibiotic

Question 31

What makes up the nasal pyramid

Answer 31

Upper 1/3 bony vault Middle 1/3 cartilage vault Lower 1/3 cartilage vault

Question 32

What can happen to the nasal septum in trauma

Answer 32

It can be dislocated off of the floor of the nose without the nasal bones being affected

Question 33

What could happen if a nasal trauma-septal haematoma was left

Answer 33

It could cause the cartilage of the nose to fold and become crumpled as it does not have its own blood supply Death of cartilage

Question 34

What is a rhinoplasty

Answer 34

Where the nasal bones need to be brought together to ultimately improve the airway

Question 35

What condition can males get that females can't in the nose

Answer 35

Angiofibroma

Question 36

If a child presents with unilateral nasal discharge what is the most likely cause and what should you do

Answer 36

Foreign body | Refer urgently

Question 37

If an adult presents with unilateral nasal discharge what is the most likely cause and what should you do

Answer 37

Paranasal tumour | Refer urgently

Question 38

What is a complication of acute sinusitis

Answer 38

Orbital cellulitis

Question 39

What should you do for a patient with a suspected orbital cellulitis

Answer 39

Emergency referral Scan Drain the puss before loss of vision occurs