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CMI - Fall 2011

Non-specific URI aka? Common cold
Avg duration of URI? ~1wk
Most common cause of URI? Rhinovirus
What to caution involving nasal decongestants? Only use 3 days MAX!! at a time. Nasal passages get used to the med and will have bad rebound if use too long and then stop.
Who should not use decongestants? Young children, Htn, tachy
Length of course of acute viral rhinitis? 7-14 days
Bacteria in sinuses can? ^ mucus production
What is the ostio-meatal complex? Anterior Ethmoid, Frontal, Maxillary sinuses drain into this to the middle meatus
Acute bacterial rhinosinusitis involves? Swelling of nasal and sinus mucosa near the drainage pores of the sinuses
MC pathogen of acute bacterial rhinosinusitis? H.flu, S.pneumo M.Cat more common in children
Which sinus is MC affected in acute bacterial rhinosinusitis? Maxillary sinus (is the largest)
Major signs for acute bacterial rhinosinusitis? Facial pain, Nasal obstrux, nasal or postnasal d/c / purulence, Anosmia, Fever, Duration of sxs>10 days
Time frame for acute vs subacute vs chronic rhinosinusitis? <4wks, 4-12 wks, >12 wks
4 or more episodes of acute rhinosinusitis per yr is termed? Recurrent Acute
Sinus CT: w/ or w/o contrast? W/O
Abx for acute bacterial sinusitis? Start w/ amoxicillin
Maxillary sinus is MC for acute and chronic bacterial sinusitis, what is the 2nd MC? Ant Ethmoid
Which complication is more likely to occur with an infection involving the ethmoid sinuses? Orbital cellulitis/abscess
What is a risk for a critically ill pt that has had a NG tube for a prolonged pd of time? Nosocomial bacterial sinusitis
What is a rare infection that you may see in those w/ poorly controlled DM or immunocomp? Acute Invasive fungal sinusitis (spreads rapidly-can be lethal)
Sxs for how long in chronic rhinosinusitus? 12 wks or more
What are the 4 cardinal signs of chronic rhinosinusitis along with mucosal inflamm? 1. Ant/Post mucopurulent drainage 2. Nasal obstruction/congestion 3. Facial pain, pressure, or fullness 4. Decrsd sense of smell
With repeated failures of abx therapy and a course that meats chronic criteria...what may is be? Chronic FUNGAL sinusitis (non-invasive: colonizes in mucus, not cells)
What condition may involve a hx of nasal polyposis and asthma and possibly multiple sinus surgeries? Allergic fungal sinusitis
Some ex's of systemic meds that can cause rhinitis? OCP, ED drugs, some anti-HTN, aspirin, NSAIDs, SSRIs
If child has many exposures to various viruses when young, it will decrease the likelihood of what? Having allergic [rhinitis] issues
Allergic rhinitis involves? Specific proteins being inhaled and binding to IgE in the nasal mucosa and causing symptoms
Allergic rhinitis is similar to viral rhinitis, except? May be seasonal; often accompanied by eye sxs (no fever, bc not infectious)
What is assoc with long-standing allergic rhinitis? Polyps
What are the dark circles around the eyes (esp under the eyes) called and what causes them? Allergic shiners -D/t allergic rhinitis (^d blood flow around the sinuses)
WHat are Dennie-Morgan lines and what are they assoc w/? Creases below the lower eyelids, secondary to edema or thickening (allergic rhinitis)
What is the nasal crease called that is usually caused by repeatedly wiping the nose in an upward direction d/t persistent rhinorrhea? Allergic salute
WHat will nasal cavity look like in allergic rhinits? Pale bluish-gray nasal mucosa; multiple stringy mucous bands
If an inhaled corticosteroid cannot be used an allergic rhinitis pt, what may be used? Leukotriene receptor antagonist (Singulair)
What is the non-allergic, idiopathic rhinitis that involves an enhanced reactivity of nasal mucoas to various triggers? Vasomotor rhinitis (NO IgE response)
Etiology of vasomotor rhinitis? D/t imbalance in fxn of nerves that cause mucous glands to secrete fluid and BVs to swell or contract
Vasomotor rhinitis may be mixed with? Allergic rhinitis
Distinguishing features of vasomotor rhinitis? -Less common to see sneezing, itching, eye sxs -Typically dev later in life; >20 -Usually no fam hx of atopy
Vasomotor rhinitis is a common cause of what, in the elderly? Clear rhinorrhea
What condition can result from prolonged use of nasal decongestants? Rhinitis medicamentosa
Pharyngeal tonsils AKA? Adenoids
What is the MC cause of nasal obstrux in children? Adenoid hypertrophy
Adenoids in adulthood? Typically absent; regress just b4 puberty
Location of adenoids? Back of throat, just above palate (when enlarged-cuts off drainage passageway)
What composes Waldeyer's ring? Adenoids (Pharyngeal tonsils), Tubal tonsils, Palatine tonsils, Lingual tonsils
WHat is adenoid facies? Characteristic facial appearance caused by persistent mouth breathing d/t nasal obstrux in childhood-elongated face, high arched palate, prominent front upper teeth
What is Samter's triad? Asthma, Aspirin allergy, Nasal polyps
What condition is pretty commonly assoc w/nasal polyps? CF
What is the congenital blockage or narrowing of the posterior nasal airway by membrane or bone? Choanal Atresia
Babies are obligate.....breathers? Nasal
What is the benign highly vascular tumor condition that can arise in males age 7-19 yo? (in nasopharynx) Juvenile Nasal Angiofibroma
What are the MC presenting sxs w/ juvenile nasal angiofibroma? Recurrent epistaxes, obstruction
Created by: ferrier.kath
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