NOSE CLIN MED

Allergic Rhinitis Signs/Symptoms and physical exam findings

Pale, grey mucous membrane, Itchy, red, watery eyes, runny nose, stuffiness, sneezing, postnasal drip, cough, allergic shiners, dennie-morgan lines, allergic salute, allergic facies in children

Allergic Salute

A horizontal nasal crease from frequent upward rubbing of the nose.

Dennie-Morgan Lines

Prominent folds beneath the lower eyelids, often linked to allergic conjunctivitis.

Alllergic Shiners

Dark circles and puffiness under the eyes caused by venous congestion.

allergic facies

characteristic facial apeparance in chidlren include highly arched palate, mouth breathing, dental malocclusion, jaw back

Allergic Rhinitis TX

Avoidance, antihistamines, nasal steroids, immunotherapy

Vasomotor Rhinitis etiology

Nonallergic, abnormal autonomic (cholinergic) response, irritants (smoke, odors, food)

vasomotor rhinitis signs and symptoms and pe findings

Chronic congestion, rhinorrhea, sneezing, postnasal drip, cough, no itching, Swollen, congested membranes; nonallergic history

vasomotor rhinitis tx

Irritant avoidance, saline spray, nasal steroids, anticholinergic/antihistamine sprays

Rhinitis Medicament osa cause

A condition resulting from the overuse of topical nasal decongestants, leading to rebound nasal congestion and dependence on treatment.

rhinitis mediament osa signs and symptoms and pe findings

Rebound nasal congestion, postnasal drip, persistent nasal obstruction, nasal mucosa inflammation, and a history of topical decongestant use.

rhinitis mediament osa tx

Discontinuation/cold turkey of decongestants, intranasal steroids, saline spray, and oral steroids if severe

Kartagener’s Syndrome cause

A genetic disorder characterized by situs inversus, chronic sinusitis, and bronchiectasis due to defects in ciliary function.

Kartagener’s Syndrome sign and symptom and pe findings

Frequent sinus/resp infections, ear infections, chronic congestion

Nasal Polyps cause

chronic allergic rhinitis, asthma, irritation

Nasal Polyps symptoms and pe findings

obstruction, congestion, decreased smell, gray/white MASSES, BILATERAL teardrop/grape MASSES

nasal polyp tx

Nasal steroids, surgery for obstruction

Nasal Septal Perforation cause

trauma, infection ,drugs (cocaine) repeated surgery, sprays

Nasal Septal Perforation signs and symptoms and pe findings

Nosebleeds, whistling, anosmia, obstruction, visible perforation in septum

nasal septal perforation tx

Remove cause, moistening, septal button

acute sinusitis cause

viral URI (adenovirus, rhinovirus), may be bacterial (S. pneumoniae, h.flu)

acute sinusitis signs and symptoms and pe findings

Stuffy/runny nose, facial/ear pain, cough, fever (bacterial: persistent/worsening), Tenderness over sinuses, thick/colored secretions

acute sinusitis tx

Viral: supportive (analgesics, saline, steroids)
Bacterial: amox-clavulanate, doxycycline

chronic sinusitis cause

Long-term inflammation, polyps, deviation, allergies, irritants

chronic sinusitic symptoms, pe findings

>12w congestion, mucous, facial pain, decreased smell, jaw/ear pain, Endoscopic/radiologic inflammation

chronic sinusitis tx

Avoid irritants, saline, antibiotics, steroids, immunotherapy, surgery, imaging

fungal sinusitis cause and populations

Aspergillus (immunocompetent), mucor (immunocompromised), IMPACTS DIABETIC PT AND IMMUNOCOMPROMISED

fungal sinusitis symptoms and pe findings

Pain, headache, facial swelling (invasive), "fungus ball" (noninvasive), Necrotic tissue (invasive), clumps in sinuses

fungal sinusitis tx

Surgery (clear sinus), anti-fungal therapy (esp. if invasive)

nasal vestibulitis cause

Staph infection from trauma, picking, excessive blowing

nasal vestibulitis symptoms and pe findings

Swelling, erythema, pustule/abscess, tenderness, Inflamed vestibule, possible abscess

nasal vestibultiis tx

Topical mupirocin, oral/IV anti-staph antibiotics, drainage

Nasal Fracture cause

trauma, sports

nasal fracture symptoms and pe findings

Pain, swelling, deformity, epistaxis, septal hematoma risk, Displaced bone/cartilage, septal hematoma

nasal fracture tx

Treat hematoma with I&D, avoid plain films, CT facial bones for severe