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33 Cards in this Set

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