Term
what color is discharge in acute viral rhinitis
what is most common virus |
|
Definition
|
|
Term
| tests for acute viral rhinitis |
|
Definition
H and P
will show erythematous, edematous mucosa and watery discharge |
|
|
Term
| treatment for acute viral rhinitis |
|
Definition
decongestants
nasal saline
acetaminophen or NSAIDs |
|
|
Term
| how long does acute viral rhinitis usually occur |
|
Definition
7-14 days and is self limited
no longer than 4 weeks by definition |
|
|
Term
eustachian tube dysfunction
transient middle ear effusion
secondary bacterial sinusitis
AOM
asthma or CF exacerbation are all complications of: |
|
Definition
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Term
| predictors of bacterial rhinosinusitis |
|
Definition
maxillary tooth pain/face pain
poor response to decongestants
condition worsens after brief period of getting better
purulent secretions
duration of sxs >10-14days |
|
|
Term
must have two major
or
one major + two minor
or
w/ purulent drainage |
|
Definition
| to dx acute bacterial rhinosinusitis |
|
|
Term
| major signs of acute bacterial rhinosinusitis |
|
Definition
face pain
nasal obstruction
nasal/postnasal disccharge/purulence
hyposmia/anosmia
fever |
|
|
Term
| minor signs of acute bacterial rhinosinusitis |
|
Definition
HA
halitosis
fatigue
dental pain
cough
ear pain |
|
|
Term
| most common sinus effected in acute bacterial rhinosinusitis |
|
Definition
| maxillary, ethmoids, frontal, sphenoid |
|
|
Term
| if pt fails to resolve w/ tx of acute bacterial sinusitis what should you do and why |
|
Definition
| sinus CT to check for more sinister illness |
|
|
Term
| tx for acute bacterial rhinosinusitis |
|
Definition
abx (amox)
decongestant
nasal saline
NSAIDs |
|
|
Term
| classifications of rhinosinusitis |
|
Definition
acute (bacterial or viral) <4wks
sub-acute 4-12wks
chronic >12wks
recurrent acute- 4 or more episodes per year w/ interim sxs resolution |
|
|
Term
| in acute bacterial sinusitis, what warrents an urgent CT scan and referral |
|
Definition
any change in:
- ocular exam
- mental status
or presence of:
|
|
|
Term
| d/t infection of maxillary and ethmoid sinus infections, common complications of acute bacterial sinusitis include: |
|
Definition
-orbital cellulitis and abscess
-osteomyelitis
-intracranial extension
-cavernous sinus thrombosis
-meningitis |
|
|
Term
a rare medical and surgical emx that occurs in the immunocompromised or DM
spreads rapidly and potentially lethal |
|
Definition
| acute invasive fungal sinusitis |
|
|
Term
| what is required for dx acute invasive fungal sinusitis |
|
Definition
| level of suspicion and nasal bx |
|
|
Term
| how long must rhinosinusitis be present to call it chronic and what are the four cardinal signs |
|
Definition
12wks or more
1. ant and/or post mucopurulent drainage
2. nasal obstruction/congestion
3. facial pain, pressure or fullness
4. decreased sense of smell
at least 2 must be present plus documentation of mucosal inflammation |
|
|
Term
| compare pathogens of acute and chronic sinusitis |
|
Definition
acute: (3) S. pneumo, H. flu, M. cat
chronic: (multiple) above three and S. viridans, S. intermedius, P. aeruginosa, Nocardia, anaerobes |
|
|
Term
| tests for chronic sinusitis |
|
Definition
CT of sinuses: what causing such a long condition? polpys? structural obstruction?
endoscopic culture of sinus contents
allergy testing if allergy suspected
immune workup if deficiency suspected |
|
|
Term
| treatment of chronic sinusitis |
|
Definition
refer to ENT (surgical consideration)
control allergies, GERD, environment |
|
|
Term
| patient education for chronic sinusitis |
|
Definition
cannot be cured in most patients
therapy is inteded to reduce sxs and improve QOL
goals:
- control mucosal inflammation and edema
- maintenance of sinus ventilation and drainage
- tx of colonizing or infecting organisms
- reduction in number of acute exacerbations
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