-
With infectious rhinitis, secretions are ________.
mucopurulent
-
Nasal smear for infectious rhinitis would show?
- neutrophils
- bacteria
- debris
-
Color of turbinates for infectious rhinitis? Allergic rhinitis?
- infectious = red
- allergic = bluish/pale
-
Boggy, edematous mucous membranes; dark circles under eyes; mouth breathing; fever is rare; pale mucous membranes.
allergic rhinitis
-
With vasomotor rhinitis, ther is minimal __________ and nasal obstruction is aggravated by changes in ________ or exposure to irritants such as tobacco smoke.
- itching, sneezing, rinorrhea
- temperature/humidity
-
Persistent illness or nasal discharge of any quality, or daytime cough, or both lasting more than 10 days w/o improvement.
Acute bacterial sinusitis
-
A worsening course of URI or new onset of nasal discharge, daytime cough, or fever after initial improvement.
Acute bacterial sinusitis
-
Severe onset of URI w/ fever > 102.2 and purulent nasal discharge for at least 3 days.
Acute bacterial sinusitis
-
Cough is worse when ___________ with acute bacterial sinusitis.
lying down
-
Beefy red turbinates is a sign of?
acute bacterial sinusitis
-
For sinusitis in kids younger than 2 yrs, uncomplicated & kid does not attend day care and no recent abx tx in last month, what is tx?
Amox 45mg/kg/day BID x 14 days
-
For a child younger than 2 yrs with sinusitis in a community with a high prevalence of nonsusceptible S. pneuma, how do you treat?
Amox 80-90 mg/kg/day BID x 14 days
-
For a child older than 2 yrs with sinusitis & moderate or severe s/s, attends child care, or who has recently been treated with abx within last month, what is tx?
amox/clav 80-90 mg/kg/day BID x 14 days
-
What tx can be used for sinusitis if child is vomiting or unable to tolerate po meds or unlikely to comply with po meds?
single dose cetriaxone 50 mg/kg IM
-
Complaint of obstruction on one side of nose after trauma can be a sign of?
septal hematoma
-
Tx of broken nose.
- ice
- acetaminophen
- head elevation
-
When can broken nose be reduced?
- within 1-3 hours after injury or
- 5-10 days pst trauma
- (fibrous union occurs 2-3 weeks post injury)
-
tx for septal hematoma
broad spectrum abx
-
Acute sinusitis usually follows what?
acute viral URI
-
Abrupt onset of nasal congestion, purulent nasal discharge, headache that becomes more intense with bending over, fever, fatigue.
bacterial sinusitis
-
First line choice abx for adults with acute sinusitis.
Augmentin x 5-7 days
-
Tx for sinusitis if PCN allergy.
- doxycycline if > 8 yrs
- respiratory quinilone if > 18 yrs
-
What is not recommended as tx for sinusitis?
decongestants or antihistamines
-
In ________ sinusitis, nasal drip and cough are often present and symptoms are worse at night when in supine position.
chronic
-
Tx for chronic sinusitis.
Beta lactase 2-4 wks (rx by ENT)
-
Limit use of OTC nasal sprays to ________.
three days
-
Tx for chronic nasal congestion.
depends on cause
-
________ may be an effective tx for allergic rhinitis but slow onset. Best to use this to pre-treat or take daily.
Intranasal steroids
-
__________ is an INeffective decongestant and poses a stroke risk in the elderly.
- Phenylephrine (Sudafed PE) &
- Pseudoephedrine (Sudafed)
-
Some ________ can cause rebound congestion and should not be used longer than _________.
- OTC nasal sprays
- three days
-
The presence of ______ excludes dx of vasomotor rhinitis.
polyps
-
Tx of vasomotor rhinitis.
- oral decongestant q 6 hrs
- intranasal steroids
- *does NOT respond to antihistamines
-
What is hyposmia?
Smell distortion
-
What is hypogeusia?
diminished taste
-
What is aliageusia?
unpleasant taste
-
What is dysgeusia?
persistant taste
-
Most common malignant tumor of nose.
squamous cell carcinoma
-
Most common benign tumor of nose.
inverted papilloma (from wall b/w nose & maxillary sinuses)
-
Tx for nasal trauma.
- (refer to ER immediately)
- Cool localized pressure
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