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33 Cards in this Set
- Front
- Back
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What is the most common site of epistaxis?
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Kiesslebach's plexus
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What is the location of posterior nose bleeds?
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Woodruff's plexus
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Why are antibiotics given when packing the nose?
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prevents toxic shock syndrome
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What are treatment options of epistaxis?
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• pressure
• chemical cauterization • packing |
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What medications can a patient be placed on if their adenoids are causing partial obstruction?
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• antihistamines
• antidecongestants |
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What are indications for adenoidectomy?
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• 4 or more episodes of purulent rhinorrhea in 12 months
• sleep distrubance with nasal airway obstruction persisting for at least 3 months • hyponasal or nasal speech • otitis media with effusion > 3months • dental malocclusion or orofacial growth disturbancve • polysomnography or sleep tape recording showing documentation of snoring or apnea |
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Name and describe the 3 types of sleep apnea
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• central sleep apnea:
- secondary to CNS problem - occurs without respiratory effort - more common in children • obstructive sleep apnea: most common sleep apnea • mixed sleep apnea: combination found most commonly in infants |
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What are complications of sleep apnea?
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• cardiovascular HTN
• CVA • erectile dysfunction • MI • motor vehicle accidents • pulmonary HTN |
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What are treatment options of mild obstructive sleep apnea?
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• weight loss
• oral appliance • adjunctive TX (ex. nasal steroids, sleep hygiene, avoid CNS depressants) |
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What are treatment options for moderate & severe obstructive sleep apnea?
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• CPAP
• surgery |
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Which pathogens commonly cause sinusitis?
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• H. Flu (38%)
• Strep pneumo (37%) • Strep pyogenes (6%) • Moraxella cararrhalis (5%) • Alpha streptococci (3%) • mixed anaerobes (3%) |
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What are treatment options for mild sinusitis?
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• Amoxicillin (with or without clavulanate)
OR • Erythromycin + Bactrim |
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What are treatment options for moderate/severe sinusitis?
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• Augmentin
• Cefpodoxime • Cefuroxime • Levofloxacin • Gatifloxacin |
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What are factors that suggest acute bacterial sinusitis instead of a viral infection?
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• worsening of symptoms after 5 days
• persistence of symptoms > 10 days • symptoms out of proportion to those typically associated with viral infection |
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What are predisposing factors for acute bacterial sinusitis?
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• allergic rhinitis
• anatomic variation (ex. deviated septum, cleft palate, etc.) • dental infections or extractions • environmental factors (ex. tobacco smoke, air pollution) • genetic predisposition • iatrogenic factors (ex. intubation, mechanical ventilation) • immunodeficiency or immature immune system |
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What are major symptoms suggesting acute bacterial sinusitis?
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• facial pain
• hyposmia/anosmia • nasal drainage • nasal obstruction/congestion • postnasal drip/purulence |
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What are minor symptoms that suggest acute bacterial sinusitis?
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• cough
• ear fullness/pressure • fatigue • fever • headache • maxillary dental pain |
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What diagnostic study is gold standard in diagnosing sinusitis?
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CT scan (coronal view)
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What causes nasal polyposis?
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usually secondary to chronic mucosal inflammation
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What are treatment options for nasal polyposis?
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• eliminate cause (ex. allergen/irritant)
• oral/topical steroids • surgical removal |
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What are the 3 types of allergies?
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• inhalant allergies (ex. allergic rhinitis, non-allergic rhinitis, asthma)
• ingested allergies (ex. foods, medications) • contact allergies (ex. latex, cosmetics) |
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What are the different classifications of allergic rhinitis?
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• seasonal
• perennial • both |
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What are the different classifications of non-allergic rhinitis?
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• perennial non-allergic rhinitis
• infectious • rhinitis medicamentosa • hormonal • anatomical |
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What are triggers of seasonal allergic rhinitis?
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pollen
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What are triggers of perennial allergic rhinitis?
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• animal dander
• dust mites • mold |
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What are triggers for perennial nonallergic rhinitis?
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• air pollutants (ex. smoke)
• change in temp, humidity, air pressure • strong odors |
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What are over-the-counter medications used to treat allergic and non-allergic rhinitis?
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• mast cell stabilizer (ex. intranasal cromolyn sodium)
• antihistamines (ex. claritin, benadryl) • decongestants • intranasal saline |
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What patients should not be given decongestants?
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pts with hypertension
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What are prescription medications used to treat allergic and non-allegic rhinitis?
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• antihistamines
• anticholinergics (ex. Atrovent) • corticosteroids • decongestants • leukotriene blockers (ex. Singulair) |
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How long should intranasal steroids be used to maintain clinical benefit?
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5-14 days
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What are potential causes and aggravating factors of urticaria?
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• drugs
• foods • heat & exercise • infections • sensitivity to animals, plants, latex • thyroid disorders |
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What is the most common cause of angioedema?
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ACE inhibitor sensitivity
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What are treatment options of angioedema?
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• Antihistamine (H1 blocker)
• antacid (H2 blocker) • steroids • antidepressants (ex. Doxipen, Effexor) |
