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Infections and Disorders of the Nose and Sinus
Clinical Medicine ENT
23
Medical
Graduate
12/02/2010

Additional Medical Flashcards

 


 

Cards

Term

what color is discharge in acute viral rhinitis

 

what is most common virus

Definition

clear

 

rhinovirus

Term
tests for acute viral rhinitis
Definition

H and P

 

will show erythematous, edematous mucosa and watery discharge

Term
treatment for acute viral rhinitis
Definition

decongestants

 

nasal saline

 

acetaminophen or NSAIDs

Term
how long does acute viral rhinitis usually occur
Definition

7-14 days and is self limited

 

no longer than 4 weeks by definition

Term

eustachian tube dysfunction

 

transient middle ear effusion

 

secondary bacterial sinusitis

 

AOM

 

asthma or CF exacerbation are all complications of:

Definition
acute viral rhinitis
Term
predictors of bacterial rhinosinusitis
Definition

maxillary tooth pain/face pain

 

poor response to decongestants

 

condition worsens after brief period of getting better

 

purulent secretions

 

duration of sxs >10-14days

Term

must have two major

or

 

one major + two minor

 

or

w/ purulent drainage

Definition
to dx acute bacterial rhinosinusitis
Term
major signs of acute bacterial rhinosinusitis
Definition

face pain

nasal obstruction

nasal/postnasal disccharge/purulence

hyposmia/anosmia

fever

Term
minor signs of acute bacterial rhinosinusitis
Definition

HA

halitosis

fatigue

dental pain

cough

ear pain

Term
most common sinus effected in acute bacterial rhinosinusitis
Definition
maxillary, ethmoids, frontal, sphenoid
Term
if pt fails to resolve w/ tx of acute bacterial sinusitis what should you do and why
Definition
sinus CT to check for more sinister illness
Term
tx for acute bacterial rhinosinusitis
Definition

abx (amox)

decongestant

nasal saline

NSAIDs

Term
classifications of rhinosinusitis
Definition

acute (bacterial or viral) <4wks

 

sub-acute 4-12wks

 

chronic >12wks

 

recurrent acute- 4 or more episodes per year w/ interim sxs resolution

Term
in acute bacterial sinusitis, what warrents an urgent CT scan and referral
Definition

any change in:

  • ocular exam
  • mental status
or presence of:
  • periorbital edema

Term
d/t infection of maxillary and ethmoid sinus infections, common complications of acute bacterial sinusitis include:
Definition

-orbital cellulitis and abscess

 

-osteomyelitis

 

-intracranial extension

 

-cavernous sinus thrombosis

 

-meningitis

Term

a rare medical and surgical emx that occurs in the immunocompromised or DM

 

spreads rapidly and potentially lethal

Definition
acute invasive fungal sinusitis
Term
what is required for dx acute invasive fungal sinusitis
Definition
level of suspicion and nasal bx
Term
how long must rhinosinusitis be present to call it chronic and what are the four cardinal signs
Definition

12wks or more

 

1.  ant and/or post mucopurulent drainage

2.  nasal obstruction/congestion

3.  facial pain, pressure or fullness

4.  decreased sense of smell

 

at least 2 must be present plus documentation of mucosal inflammation

Term
compare pathogens of acute and chronic sinusitis
Definition

acute:  (3) S. pneumo, H. flu, M. cat

 

chronic:  (multiple) above three and S. viridans, S. intermedius, P. aeruginosa, Nocardia, anaerobes

Term
tests for chronic sinusitis
Definition

CT of sinuses:  what causing such a long condition?  polpys?  structural obstruction?

 

endoscopic culture of sinus contents

 

allergy testing if allergy suspected

 

immune workup if deficiency suspected

Term
treatment of chronic sinusitis
Definition

refer to ENT (surgical consideration)

 

control allergies, GERD, environment

Term
patient education for chronic sinusitis
Definition

cannot be cured in most patients

 

therapy is inteded to reduce sxs and improve QOL

goals:

  • control mucosal inflammation and edema
  • maintenance of sinus ventilation and drainage
  • tx of colonizing or infecting organisms
  • reduction in number of acute exacerbations

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