Term
| Babys can get sinusitis but it is abnormal. Babies have frontal and maxiallary sinuses. |
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Definition
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Term
| In __ sinusitis, pts teeth may hurt. |
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Definition
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Term
| Allergic rhinitis is __ common between men and women. 80% have the onset before age __. Mean age of onset is __. |
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Definition
- equally
- 20
- 10
If baby has it and not sure to diagnose it or not, ask family history of allergic dermatitis. If mom has allergies or dad, probably allergies in baby. |
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Term
| Allergic rhinitis is a __ __ interaction. It may take years to become __. It is __ mediated and __ __ __ occurs. |
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Definition
- antibody-antigen interaction
- sensitized
- IgE
- mast cell degranulation
primary inflammatory mediators: histamine, kinin, heparin
secondary inflammatory mediators: prostaglandins, LTRs |
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Term
| With allergic rhinitis, inflammatory agents induce: |
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Definition
- mucuous glands
- vasodilation
- increased vascular permeability
- sensory nerve stimulation |
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Term
| Whats involved with allergic rhinitis: |
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Definition
NOT JUST THE NOSE
- nose
- eyes
- ears
- skin |
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Term
| REMEMBER BLOOD PRESSURE AND ALLERGY MEDICINE INTERACTIONS. HAVE TO TELL YOUR PATIENT THAT THE MEDS CAN RAISE THERE BLOOD PRESSURE. Must consider the meds they are currently on. If they have frequent URIs need to know why, could be lymphoma or other cancers. |
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Definition
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Term
| symptoms of allergic rhinitis: |
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Definition
- sneezing
- rhinorrhea
- nasal congestoin
- scratchy sore throat
- pruritis
- tearing
- cough
- snoring
- sniffles
- anosmia
- headache
- fatigue |
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Term
| signs of allergic rhinitis: |
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Definition
- allergic shiners
- nasal crease
- pale/bluish boggy mucosa
- cobble stoning
- clear mucous
- polyps
- septal issues |
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Term
| DDx of allergic rhinitis: |
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Definition
- vasomotor rhinitis
- rhinitis medicamentosa
- immotile cilia syndrome
- CSF leakage
- Granulomatous rhinitis
(Very Right Is Commonly Good). |
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Term
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Definition
smell reactions to perfume/garlic/onions etc.
ANTIHISTAMINES WON'T WORK FOR THIS |
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Term
| Rhinitis medicamentosa occurs in pts who use __ too often, to the point that when they don't use it, their nose gets clogged. |
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Definition
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Term
| GRANULOMATOUS RHINITIS: WEGENERS GRANULOMATOSIS AND LYMPHOMA CAN CAUSE THIS |
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Definition
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Term
| diagnostic studies for allergic rhinitis: |
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Definition
NOT ROUTINE
Allergy testing
In vitro
In vivo
Nasal smear and eosinophil count (both uncommon)
eusionphils- orange granules with purple nucleus |
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Term
| 3 tmt options for allergic rhinitis: |
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Definition
Basically three options:
Environmental control (allergen avoidance)
Pharmacotherapy
Immunotherapy |
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Term
| 6 possible classes of drugs used to treat allergic rhinitis: |
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Definition
- Steroids
- Antihistamines
- Decongestants
- Mast cell stabilizers
- LTR antagonists
(SADAML) |
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Term
| steroids for allergic rhinitis can be give __, __, or __. |
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Definition
- intranasaly
- orally
- parenterally |
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Term
Antihistamines
1st generation
Diphenhydramine, et al
2nd generation
Cetirizine, et al
3rd generation
Levocetirizine
Intranasal
Azelastine, et al
Intraocular
Olopatadine, et al |
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Definition
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Term
| Antihistamine pneumonic: (Did Carl Leave An Option) |
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Definition
- 1st generation: Dephenhydramine
- 2nd generation: Cetirizine
- 3rd generation: Levocetirizine
- Intranasal: Azelastine
- Intraocular: Olopatadine |
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Term
| A decongestant used for allergic rhinitis is __. |
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Definition
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Term
| An anticholinergic used for allergic rhinitis is ___. This is rarely used though b/c it dries out the nose so much and can cause __ __. |
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Definition
- Ipatropium
- nose bleeds |
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Term
| A mast cell stabilizer that can be used with allergic rhinitis is __. |
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Definition
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Term
| A LTR antagonist that can be used for allergic rhinitis is __. |
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Definition
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Term
| Immunothearpy is aka __ __. |
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Definition
allergy vaccination
Very effective
Long term
Expensive but…
Shots
Some risk
<1 death/million
Many never complete the course of Tx |
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Term
Viral rhinitis:
Strongly seasonal
Symptoms >> findings
Vitals normal
Mucous
Pink to reddish mucosa
Oral exam normal-ish
Chest clear |
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Definition
Bacterial rhinitis:
Less seasonal
Symptoms = findings
Temp… but
Mucous
Red mucosa
Purulent postnasal drip
Chest variable |
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Term
Viral they don’t look that bad its just a cold.
Bacterial- they look as bad as they feel.
Common cold can live on a surface 20 hours. |
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Definition
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Term
| viral rhinitis, who is likely to get this: |
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Definition
- very young and very old
- chronic illnesses
- immunocompromised |
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Term
| demographics of sinusitis: |
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Definition
- all races equally affected
- equal b/w men and women
- no specific age
- all parts of country |
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Term
| Pathogenesis of acute sinusitis: |
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Definition
- viral infection
- Strep. pneumoniae (31%)
- H. influenzae (21%)
- M. catarrhalis
TEST KNOW IT |
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Term
| pathogenesis of chronic sinusitis: |
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Definition
- Osteaomeatal complex
- S. pneumonia
- H. influenzae
- M. catarrhalis
- Anaerobes
- Fungus
TEST KNOW IT |
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Term
| signs and symptoms of acute sinusitis: |
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Definition
- purulent nasal d/c
- sinus pain
- fever
- halitosis
- headache
- often specific symptoms |
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Term
| Signs and symptoms of chronic sinusitis: |
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Definition
- long history
- maybe nasal d/c
- NO sinus pain
- Halitosis
- DENTAL PAIN
- often non-specific symptoms |
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Term
| Dx studies for acute sinusitis: |
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Definition
- maybe X-ray
- maybe CT
- no culture
- no venipunction
- no surgery |
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Term
| Chronic sinusitis dx studies: |
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Definition
- X-ray
- CT scan
- MR
- maybe culture
- maybe venipuncture
- maybe surgery |
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Term
| Treatment of acute sinusitis: |
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Definition
- Decongestants: oral, topical
- Analgesia
- Steroids
(don't rush to antibiotics, referral uncommon) |
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Term
| Treatment of chronic sinusitis: |
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Definition
- control predisposing factors like allergies or GRED
- Decongestants
- Antihistamines
- Steroids
- Antibiotics possibly
- Surgery |
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