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lecture 2 chan

dx of CSF rhinorrhea urine dip stick for glucose content, beta-2-transferrin levels are only present in CSF and not nl nasal mucus, look for "ring sign" when dripped onto paper towel
signs of chronic sinusitis intermittent facial pain & headache, evidence of thick, green, foul-smelling rhinorrhea (may also be FB like a rock or toy in children's noses)
how to distinguish viral from allergic rhinitis allergic: sneezing, watery eyes and palatal pruritis vs viral: febrile rhinosinusitis
epistaxis can be caused by bleeding disorders (on Coumadin, Plavix or has hemophilia), HTN, dry and cracked MM, trauma like digging with fingers. may rarely be neoplasm like juvenile angiofibroma
4 major causes of congestion allergies, rhinosinusitis, neoplasms, ?
genetic cause for epistaxis Osler-Weber-Rendu syndrome or hereditary hemorrhagic telangiectasia is AD dz where one develops telangiectasias in the nose that may bleed easily
evidence for presence of a FB in nostril unilateral congestion and foul-smelling rhinorrhea
polyp inflammatory growth that may cause nasal passage obstruction; are pedunculated and transulecent masses that are most common in pts with allergic rhinitis and chronic sinusitis
glossitis an abnormally smooth tongue may be evidence of a vitamin deficiency
aphthous ulcers aka canker sores: small, painful ulcers in the oral mucosa, ulcerated and inflamed regions that resolve over time
leukoplakia white patch on tongue or in oral mucosa that may indicate a premalignant state
streptococcal pharyngitis exam should show white plaques on a reddened pharynx
peritonsillar abscess painful, red bulging of the tissues surrounding the tonsils with possible deviation of uvula to the opposite side and impingement on the pterygoids causing trismus
intermittent hoarseness in a pt with nasal d/c, itchy nose, eyes and soft palate hoarseness most likely due to allergic rhinitis
cardinal finding of laryngeal carcinoma hoarseness; may indicate a pure laryngeal neoplasm or a lung neoplasm that has disrupted the recurrent laryngeal nerve
viral laryngitis typically associated with exposure to infectious agents
stridor noisy breathing from laryngeal level, could be due to infection, developmental abnormalities, trauma or neoplasms
lateral XR vs AP films may reveal narrowing of the airway or thickening of epiglottis // AP: best for r/o croup
CT vs MRIs CT has better resolution of bone structural abnormalities like skull base dehiscence and in the sinuses whereas MRI has better resolution of soft tissue structures
Created by: sirprakes