Nose-ENT

Question 1

differential for nasal obstruction

Answer 1

congenital- choanal atresia
anatomical- deviated septum
FB
inflammatory
neoplastic

Question 2

inflammatory causes for nasal obstruction

Answer 2

• polyp
• sarcoid
• wegners

Question 3

neoplastic cases for nasal obstruction

Answer 3

• papilloma
• SCC
• juvenile nasopharyngeal angiofibroma
• inverted papilloma

Question 4

empiric tx nasal obstruction

Answer 4

STEROIDS- spray
DECONGESTANT- spray or drops
ANTIBIOTICS

Question 5

dx of nasal obstruction

Answer 5

pan-endscopy

fog-up mirror test

Question 6

red flag symptoms for nasal obstruction

Answer 6

UNI-epistaxis
UNI-blockage
UNI-swelling
ear effusion
neck swelling
atypical pain

Question 7

tx allergic rhinitis

Answer 7

• topical steroid spray
• nasal douches– neilmed + streimar
• surgery– diathermy/ turbinate reduction
• FESS

Question 8

nasonex

Answer 8

mometasone furoate monohydrate + glucocorticoids

>12yo

Question 9

avamys

Answer 9

fluticasone furoate + glucocorticoids

Question 10

rynacrom

Answer 10

sodium cromoglycate

Question 11

atrovent

Answer 11

ipratropium bromide

Question 12

PC nasal polyps

Answer 12

BILATERAL

• anosmia
• nasal obstruction
• sneezing
• rhinorrhea
• pale
• boggy edematous mucosa

Question 13

tx nasal polyps

Answer 13

steroids

surgery– FESS, polypectomy

Question 14

steroids for nasal polyps

Answer 14

spray– 6 months
drops– 2-3weeks
oral– 10 days

Question 15

MCC unilateral polyp

Answer 15

inverted papilloma

Question 16

Dx- inverted papilloma

Answer 16

MUST BIOPSY– since can go on to SCC

Question 17

inverted papilloma associated with

Answer 17

MENINGOCELE

Question 18

dx nasal polyps

Answer 18

endoscopy–pale and grey polypoid mass

- bogy and oedematous mucosa

Question 19

dx nasal polyps imaging:

Answer 19

CT paransal sinuses= radio-opaque

Question 20

dx of nasal FB

Answer 20

• lateral nasal XR

- CXR: inspiratory and expiratory

Question 21

tx of nasal FB

Answer 21

GA–removal

bronchoscopy if aspirate

Question 22

dx of choanal atresia

Answer 22

• fogging metal spatula
• NGT/catheter
• fibreoptic scope
• CT: bony or membranous mixed

Question 23

vaso-motor rhinitis=

Answer 23

NON-allergic rhinitis

Question 24

risk factors for non-allergic rhinitis

Answer 24

fumes/ pregnancy/ drugs

DIAGNOSIS OF EXCLUSION

Question 25

MAJOR symptoms for rhinosinusitis

Answer 25

- nasal obstruction - rhinorrhea - facial pressure - fever - olfactory changes

Question 26

minor symptoms for rhinosinusitis

Answer 26

- headache - fatigue - cough - hallitosis - dental pain - ear pain

Question 27

endoscopy findings rhinosinusitis

Answer 27

MOON Mucopurulent discharge in middle meatus Oedema / Obstruction in middle meatus Nasal polyps

Question 28

CT findings rhinosinusitis

Answer 28

mucosal changes--> osteomeatal complex and/or sinuses

Question 29

duration of acute rhinosinusitis

Question 30

duration of chronic rhinosinusitis

Answer 30

> 12 weeks-- incomplete resolution

Question 31

patient causes of rhinosinusitis

Answer 31

``` STRUCTURAL - nasal tumor - septal deviation - nasal polyp MUCOCILIARY CLEARANCE - CF - immotile cilia IMMUNODEF - HIV ```

Question 32

environmental causes of rhinosinusitis

Answer 32

``` SOC-FAM smoke occupational chemicals fungi allergens medications ```

Question 33

dx of acute sinusitis

Answer 33

endoscopy/rhinoscopy | = PUS IN MIDDLE MEATUS

Question 34

tx of acute sinusitis

Answer 34

- Abx: co-amox or vibramycin - decongest: ephedrine or otrovine - steroids - bed rest/ analgesia

Question 35

causes of chronic sinusitis

Answer 35

ANAEROBES | S.AUREUS

Question 36

dx of chronic sinusitis

Answer 36

allergy test; | exclude: polyp/ tumor/ septal deviation

Question 37

tx of chronic sinusitis

Answer 37

1. abx 2. cause 3. steroids-- topical/oral (decreases inflammation, increases drainage)

Question 38

infective viral causes of chronic sinusitis

Answer 38

rhinovirus adenovirus RSV parainfluenza

Question 39

infective bacterial causes of chronic sinusitis

Answer 39

simple syphilis TB

Question 40

non-allergic rhinitis= non-infective rhinitis=

Answer 40

non-allergic eosinophilic rhinitis - occupational - hormonal - drug induced - gustatory - vasomotor

Question 41

ARIA

Answer 41

allergic rhinitis and its impact on asthma

Question 42

seasonal causes of allergic rhinitis

Answer 42

POLLENS

Question 43

perennial causes of allergic rhinitis

Answer 43

- house dust mite - animal dander - chemicals - food - fungospores

Question 44

tx allergic rhinitis

Answer 44

1. avoid allergen 2. saline douching 3. anti-histamine 4. surgery-- obstruction only: septoplasty or turbinate reduction 5. immunotx-- desens--> sc, sublingual

Question 45

3 big indications for rhinitis surgery

Answer 45

1. COMPLICATIONS 2. FUNGAL 3. NEOPLASM suspected

Question 46

3 complications indicating need for rhinitis surgery | the intra-cranial complications

Answer 46

1. meningitis 2. abscess - brain - subperiosteal orbital 3. cavernous sinus thrombosis

Question 47

3 surgical options for rhinitis

Answer 47

- septal surgery - polypectomy - FESS

Question 48

basis behind FESS

Answer 48

unblocks osteometal complex--> aeration and drainage of sinuses; performed under image guidance

Question 49

FESS nasal complications

Answer 49

- epistaxis - infection - adhesions - anosmia/hyposmia

Question 50

FESS orbital complications

Answer 50

- haematoma | - optic nerve trauma

Question 51

FESS intra-cranial complications

Answer 51

- CSF leak | - meningitis

Question 52

rhinitis miscellaneous complications

Answer 52

- LRTI - AOM - osteomyelitis= POTTS PUFF TUMOR

Question 53

orbital complications of rhinitis

Answer 53

- abscess | - periorbital cellulitis (mc in kids, with URTI before)