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7 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Acute condition and frequently associated with a history of recent URI. Perennial but more common in winter months.
What is the DD? |
Infectious Rhinitis
Dains pg 287 Question: What are the physical findings for IR? |
Red, swollen mucosa
Yellow or green purulent discharge |
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Pale, boggy mucosa. Rhinorrhea with clear, watery mucus. Can be perennial or seasonal.
What is the DD? |
Allergic Rhinitis
Dains pg 287 Question: What are the diagnostic studies for AR? Question: What are "allergic shiners" and "allergic salute?" |
Nasal smear for eosinophils
Allergy testing Allergic shiners = dark discolored areas beneath the lower eyelids as a result of impeded lymphatic and venous drainage Allergic salute = transverse crease on tip of nose due to long-term wiping of nose in an upward direction |
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Swollen mucosa with clear mucus or dry mucosa. Hx of medication use: oral contraceptives, nasal sprays, antihypertensives, nasal congestion.
What is the DD? |
Rhinitis Medicamentosa
Dains pg 287 Question: what is the difference between rhinitis medicamentosa and infectious rhinitis in physical findings? |
RM: clear mucus
IR: purulent discharge |
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Purulent discharge; maxillary toothache on percussion or facial pain, post nasal drainage; halitosis; reduced sense of smell; morning cough; frontal headaches made worse with forward bending; fever. Common during winter months.
What is the DD? |
Sinusitis
Dains pg 287 Question: What history do you ask this patient? |
Smoking?
Recent URI? Allergies or asthma? Tooth abscess? Swimming in contaminated water? Hollier pg 202 Dains 287. |
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What are the pharmacological management for allergic rhinitis?
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1) Saline nasal spray
2) Antihistamine 3) Nasal steroids 4) Systemic steroids (avoid if possible) 5) Topical cromolyn (mast cell stabilizer) 6) Decongestants Hollier pg 190 Question: what are the complications of AR? |
1) Otitis Media
2) Sinusitis 3) Secondary infection of sinuses, tonsils, pharynx 4) Epistaxis 5) Facial changes (eg allergic salute and allergic shiners) |
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Transillumination is used to assess the presence of fluid in the ______ and ______ sinuses
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Frontal and Maxillary
Dains pg 284 Question: Where do you place the transilluminator for maxillary and frontal sinuses? |
Maxillary: Infraorbital rim or in the patient's mouth
Frontal: supraorbital rim |
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What history questions would you ask a patient with nasal congestion?
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1) Smoking (risk for sinusitis)
2) Trauma (post trauma CSF rhinorrhea) 3) Diving and swimming (secondary to barotrauma, infection from contaminated water, or allergic rxn to chlorine) 4) Exposure (viral through droplets or contacts) 5) Pregnancy (hormonal changes) Dains pg 282 Question: What kind of drugs can cause nasal congestion? |
1) Nasal spray (rebound congestion)
2) Illicit drugs (cocaine - rebound) 3) Medications (oral contraceptives, ACEI, BB, phenothiazines) Dains pg. 283 |
