Question | Answer |
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 |