Rhinitis + sinusitis

Question 1

4 general questions to ask

Answer 1

1. obs uni, bilat, or alternating?
2. duration?
3. seasonal or diurnal?
4. associated nasal Sx?
   - can see table to know what they mean

Question 2

***what are 4 warning symptoms

Answer 2

1. unilateral nasa obs.
2. severe epistaxis
3. adol male - juvenile angiofibroma
4. asian - nasopharyngeal carcinoma

Question 3

5 key questions on Hx

Answer 3

1. previous surg/trauma
2. systemic diseases
3. meds
4. drug/alc use
5. preg

Question 4

what is most common cause of rhinitis

Answer 4

allergic

Question 5

2 types of alergic rhinitis

Answer 5

1. seasonal - natures

2. perennial - dust and dander

Question 6

Sx if allergic

Answer 6

• nasal congetion
• clear runny
• nasal puritits
• itchy eyes

Question 7

Tx of allergic from best to worse

Answer 7

1. elim. cause
2. saline washes
3. intra-nasal corticosteroids
4. anti-histamine
5. decongestant - be careful
6. LTRA

Question 8

what is rhinitis medicamentosa

Answer 8

• overuse of topical decongestant
• oxymetazoline
• ## altered vasomotor tone

Question 9

what is rhinosinusitis

Answer 9

• inflammation of mucosal lining of sinuses

- acute, chronic, or recurrent acute

Question 10

3 possible etiologies of sinustis

Answer 10

1. ostial obstruciton
   - polyps, deviation, URTI
2. non-ostial obst.
   - immune
   - cilia dysfunction
3. direct extention
   - from dental

Question 11

guidelines to diagnose acute sinusitis

Answer 11

at least 2 of PODS, 1 must be O or D
Pain/pressure in face
Obstruction
Discharge
Smell - can't

Question 12

what is needs for duagnosis of acute sinusitis

Answer 12

just clincial - no imaging

Question 13

Tx of acute

Answer 13

if under 7 days - nothing

if over 7 dasy - bact. - ABs if severes, steroids if not

Question 14

what is chronic sinusititis

Answer 14

IFLAMMATRY disease involving nasal mucosa and sinuses

- like asthma

Question 15

what is guidelines for diagnosis of chronic

Answer 15

CPODS
Congestion/fullness
Pain
Obstructiokn
Discharge
Smell
- also requires scope and CT

Question 16

Tx of chronic sinusitis (4)

Answer 16

1. saline irrigations
2. topical steroids
3. ABs - once diagnoses
4. oral steroid (for polyps)

Question 17

what is this doesn’t work

Answer 17

endoscpoic Tx

- remove polyps and open sinuses

Question 18

3 general complications of sinusitis

Answer 18

1. orbital
   - cellulitis
   - abscess
2. intracranial
3. bony

Question 19

5 red flags

Answer 19

1. fever
2. visual changes
3. facial numbness
4. severe pain
5. decrease LOC