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URI/NOSE/SINUS
CMI - Fall 2011
| Question | Answer |
|---|---|
| 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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