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20 Cards in this Set
- Front
- Back
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what is one of the most common diagnoses in primary care?
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sinusitis
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what percentage of URI's in adults develop into acute bacterial rhinosinusitis?
0.5-2 % 2-5 % 5-10% 25% |
0.5 - 2 %
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what percentage of patients receive antibiotics for their non sinus infection?
10% 25% 75% 90% |
90%
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if most sinus "infections" are not bacterial what are they?
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viral stupid
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if sinus infections are bacterial what are the most common bugs involved?
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h. flu
s. pneumoniae m. catarrhalis |
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sinus infections are often secondary to ?
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blockage of the sinus osteomeatus
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if a "sinus" infection is in the first 7-10 days what is its etiology?
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viral
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what are some common d/d of sinusitis?
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allergic rhinitis
viral URi cigarrette smoking dental infection gerd cluster h/a nasal foreign body neoplasm cystic fibrosis |
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what are common s/s of sinusitis?
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nasal congestion
rhinorrhea, purulent nasal discharge post nasal drainage facial pain/pressure fever pain/pressure leaning forward malaise swollen erythematous nasal mucosa sinus tenderness to palpation |
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what labs/x-rays are required to diagnose sinusitis?
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often no labs/radiology is required
may consider ESR/CRP plain films are not very sensitive CT of sinuses is test of choice |
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what is the test of choice for sinus imaging?
-xray -CT -MRI |
CT of sinuses
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what is the tx of sinusitis?
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normally high incidence of spontaneous resolution
50-70% resolution |
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how do you tx sinusitis in the first 7-10 days?
-antibiotics -symptomatically |
symptomatically
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what is a good analgesic for the tx of sinusitis discomfort?
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motrin
tylenol |
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do mucolytics help with s/s of sinusitis?
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they might
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if no improvement in 10-14 days or worsening after 7 or if significant comorbidities, tx for bacterial sinusitis with what abx?
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-amox/clav
-trimethoprim/sulfa -azithromycin 500mg x 3 days |
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when should you refer to EnT?
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if no improvement in 3 months, recurrent or complications/co morbities, immunocomprimised, diplopia, proptosis, orbital erythema
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what are some d/d of sinusitis to be wary of?
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orbital cellulitis
proximity to para-nasal sinuses pott's puffy tumor-osteomylitis of the frontal bone cavernous sinus thrombosis (hematological spread via superior opthalmic vein or pterygoid venous plexus) |
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what is a hemotological spread of infection via the superior opthalmic vein or pterygoid venous plexus?
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cavernous sinus thrombosis
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what is it called when a pt has osteomylitis of the frontal bone?
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pott's puffy tumor
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