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25 Cards in this Set
- Front
- Back
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What time period of infection is categorized as acute rhinosinusitis?
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less than 4 weeks
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What are the common viral causes for colds (4)?
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rhinovirus
parainfluenza virus respiratory syncytial virus influenza virus |
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Which viral pathogen for colds is most common and when does its incidence peak?
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rhinovirus, peaks in fall
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RSV and influenza virus are more destructive of respiratory cilia. True or False.
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True
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When do RSV and influenza virus peak?
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winter and early spring, respectively
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Radiographs are helpful in distinguising a cold from a bacterial infection. T or F?
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False
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What are the most common causes of acute bacterial rhinosinusitis?
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s. penumoniae
h. influenzae |
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Purulent nasal discharge can distinguish a viral infection from a bacterial infection. T or F?
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False
Even with purulent discharge for at least 7 days, only 60% of maxillary taps show bacterial in high concentration. |
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What symptoms suggest that an actue RS is bacterial?
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1) symptoms suddenly worsen after several days instead of slowly improving
2) persistent severe symptoms extend beyond 7 days |
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Is there a difference between endoscopic vs maxillary puncture cultures in children vs adults?
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Inchildren, the same pathogens that cause ABRS are normally found in the nasal cavity in children, so endoscopic cultures are not a surrogate for maxillary taps.
In adults, however, there is good correlation between aspirates of purulence from the middle meatus and maxillary taps. |
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In chronic rhinosinusitis, does extent of disease on CT correlate with severity of symptoms?
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No.
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What are extrinsic causes of CRS (3)?
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1) Infectious (viral, bacterial, fungal, parisitic)
2) Noninfectious/inflammatory (allergic, Non IgE-mediated hypersensitivies, pharmacologic, irritants) 3) Disruption of normal ventilation or mucociliary drainage by (surgery, infectious, trauma) |
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What are intrinsic causes of CRS (9)?
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1)Genetic:
a)mucociliary abnormality (CF, PCD) b) structural c) immunodeficiency 2) Acquired: a)aspirin hypersensitivity b)autonomic dysregulation c)hormonal (pregnancy, hypothyroidism) d)structural (neoplasms, osteoneogenesis and outflow obstruction, retention cysts and antral choanal polyps) e)autoimmune or idiopathic (Sarcoid, Wegener's, SLE, Churg Strauss, Pemphigoid) f)immunodeficiency |
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When do frontal sinuses develop in children?
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6-8 years
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What percentage of the time does aspiration yield pus in sinuses that are completely opaque on CT? what about thickened mucous membranes with central aeration?
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80-88%
50% |
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If a child develops nasal polyps before age 10, what dx must be considered rather than allergies?
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CF
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What are the five manifestations of fungal sinusitis?
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1)invasive
2)chronic invasive 3)fungal ball 4)saprophytic 5)allergic fungal sinusitis |
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What are the five criteria for diagnosing allergic fungal sinusitis?
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1) allergic mucin
2) positive cultures 3) hyphae on path 4) radiographic findings 5) nasal polyposis |
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What fungus demonstrates narrow hyphae and regular septations with 45-degree branching?
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Aspergillus
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Which is more commonly found in invasive fungal sinusitis: aspergillus flavus or fumigatus?
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Aspergillus fumigatus - aspergillus flavus is commonly associated with indolent chronic invasive fungal disease seen in Sudan
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Serum of patients with DKA may enhance fungal growth. T or F?
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True - may be attributable to altered transferrin binding in diabetic patients. Renal dialysis and des-ferrioxamine are risk factors for mucormycosis.
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What are the dematiaceous fungi involved in AFS?
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Alternaria, Bipolaris, Curvularia.
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What are some differences in patients with AFS vs. esinophilic mucin rhinosinusitis that suggests they may be different?
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1) EMRS are nearly all asthmatic (93% vs 41%)
2) EMRS patients are older (48yrs vs 30.7yrs) 3) EMRS patients have bilateral disease (100% vs 45%) 4) EMRS patients have lower total IgE (1000 mg/dL vs 12000 mg/dL) |
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What are the Chandler classifications of orbital involvement from ethmoid sinusitis?
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1) Preseptal cellulitis
2) Orbital cellulitis 3) Subperiosteal abscess 4) Orbital abscess 5) Cavernous sinus thrombosis |
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What are indications for surgical intervention?
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1) orbital cellultitis progresses despite IV ABX
2) physical sings regress slightly for 2-3 days, then stabilize or exacerbate 3) Definite abscess on U/S or CT. 4) Loss of visual acuity |
