Adult Primary Care - Exams #1 and Final
Causes of viral rhinitis - answer #1 Rhinovirus
Coronavirus
Influenza virus
Adenovirus
What should you be worried about with viral rhinitis with smokers, elderly or
immunocompromised? - answer Their viral rhinitis may develop into pneumonia
Symptoms of viral rhinitis - answer Rhinorrhea
PND causing cough
Sore throat
Cough
Low grade fever, chills
Muscle aches
Headaches
Treatments for viral rhinitis - answer Decongestations
Expectorants, antitussives
Antipyretics
Antihistamines (H2 blocker preferred)
Rest and FLUIDS
What do you want to know r/t allergic rhinitis and medications? - answer Taking Afrin?
Risk of rebound congestion
What should you suspect with someone who has allergic rhinitis and a fever and/or
purulent drainage? - answer That they have a secondary bacterial infection --> often
progresses to sinusitis
What can longstanding allergies cause? - answer Adenoidal hypertrophy which can
increase asthma risk
What do you think when a person has blue, boggy, edematous turbinates? - answer
Allergic rhinitis
What are Dennie's lines? - answer An infraorbital fold indicative of allergic rhinitis
What can alleviate allergic shiners? - answer 2nd generation antihistamines; topical
nasal steroids
Treatment for allergic rhinitis? - answer **Allergen avoidance
Antihistamines
Decongestants
Topical nasal steroids (e.g. Rhinocort/Nasocort)
Hydration
, Adult Primary Care - Exams #1 and Final
With what condition is IgE elevated? With what condition is it normal? - answer Elevated
= allergic rhinitis
Normal = vasomotor rhinitis
What would you expect when someone complains of nasal congestion/discharge that
came on suddenly after exposure to stimuli and they have pale or hyperemic
turbinates? - answer Vasomotor rhinitis
What might you suspect after someone has had viral rhinitis for over a week (7-10
days)? - answer Sinusitis
Most common pathogens causing sinusitis - answer Strep pneumoniae
H. flu
M. catarrhalis
What would make you suspect acute sinusitis over a URI? - answer 1) Symptoms that
last over 10 days
2) Onset with severe symptoms fever (>101), purulent nasal drainage for at least 3-4
days at beginning of illness
3) Double-sickness: URI seems to be improving but suddenly symptoms worsen around
5-6 days
How quickly should antibiotics work with acute sinusitis? - answer In 24-48 hrs
How long may a patient with chronic sinusitis need to be on abx? - answer 3-4 weeks
How long do symptoms typically persist with chronic sinusitis? - answer >3 months
What may you suspect when patient has facial pain that worsens when he or she leans
forward and/or halitosis? - answer Sinusitis (pain is worse when leaning over especially
with maxillary sinusitis)
What diagnostic testing would you do with sinusitis? - answer Usually none -- may need
to do Water's view X-ray, allergy testing, would not do CT scan
How long would you treat acute sinusitis? - answer 3-4 weeks
What do you use to treat sinusitis? - answer Augmenting (amoxicillian + clavulanic acid)
Hallmark sign of otits externa - answer Very painful -- pinna and triages sign
#1 causative agent of otitis externa - answer Pseudomonas
What medication should be avoided with sinusitis? - answer Antihistamines (unless they
have allergies as well) -- will slow the movement of secretions
Causes of viral rhinitis - answer #1 Rhinovirus
Coronavirus
Influenza virus
Adenovirus
What should you be worried about with viral rhinitis with smokers, elderly or
immunocompromised? - answer Their viral rhinitis may develop into pneumonia
Symptoms of viral rhinitis - answer Rhinorrhea
PND causing cough
Sore throat
Cough
Low grade fever, chills
Muscle aches
Headaches
Treatments for viral rhinitis - answer Decongestations
Expectorants, antitussives
Antipyretics
Antihistamines (H2 blocker preferred)
Rest and FLUIDS
What do you want to know r/t allergic rhinitis and medications? - answer Taking Afrin?
Risk of rebound congestion
What should you suspect with someone who has allergic rhinitis and a fever and/or
purulent drainage? - answer That they have a secondary bacterial infection --> often
progresses to sinusitis
What can longstanding allergies cause? - answer Adenoidal hypertrophy which can
increase asthma risk
What do you think when a person has blue, boggy, edematous turbinates? - answer
Allergic rhinitis
What are Dennie's lines? - answer An infraorbital fold indicative of allergic rhinitis
What can alleviate allergic shiners? - answer 2nd generation antihistamines; topical
nasal steroids
Treatment for allergic rhinitis? - answer **Allergen avoidance
Antihistamines
Decongestants
Topical nasal steroids (e.g. Rhinocort/Nasocort)
Hydration
, Adult Primary Care - Exams #1 and Final
With what condition is IgE elevated? With what condition is it normal? - answer Elevated
= allergic rhinitis
Normal = vasomotor rhinitis
What would you expect when someone complains of nasal congestion/discharge that
came on suddenly after exposure to stimuli and they have pale or hyperemic
turbinates? - answer Vasomotor rhinitis
What might you suspect after someone has had viral rhinitis for over a week (7-10
days)? - answer Sinusitis
Most common pathogens causing sinusitis - answer Strep pneumoniae
H. flu
M. catarrhalis
What would make you suspect acute sinusitis over a URI? - answer 1) Symptoms that
last over 10 days
2) Onset with severe symptoms fever (>101), purulent nasal drainage for at least 3-4
days at beginning of illness
3) Double-sickness: URI seems to be improving but suddenly symptoms worsen around
5-6 days
How quickly should antibiotics work with acute sinusitis? - answer In 24-48 hrs
How long may a patient with chronic sinusitis need to be on abx? - answer 3-4 weeks
How long do symptoms typically persist with chronic sinusitis? - answer >3 months
What may you suspect when patient has facial pain that worsens when he or she leans
forward and/or halitosis? - answer Sinusitis (pain is worse when leaning over especially
with maxillary sinusitis)
What diagnostic testing would you do with sinusitis? - answer Usually none -- may need
to do Water's view X-ray, allergy testing, would not do CT scan
How long would you treat acute sinusitis? - answer 3-4 weeks
What do you use to treat sinusitis? - answer Augmenting (amoxicillian + clavulanic acid)
Hallmark sign of otits externa - answer Very painful -- pinna and triages sign
#1 causative agent of otitis externa - answer Pseudomonas
What medication should be avoided with sinusitis? - answer Antihistamines (unless they
have allergies as well) -- will slow the movement of secretions
