Question 1

A provider examines a patient who has chronic nasal obstruction, respiratory tract symptoms, and generalized malaise. An examination of the nasal mucosa reveals ulceration of the nasal septum. What is the most important action when caring for this patient?

A) Administering prednisone
B) Obtaining a chest radiograph
C) Performing laboratory tests
D) Referring to a specialist

D

Accepted Answer

The patient's symptoms suggest a potential diagnosis of granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis). Ulceration of the nasal septum is a classic finding in this disease. The most important action is to refer the patient to a specialist (usually a rheumatologist or pulmonologist) for further evaluation and management. Administering prednisone would be a possible treatment option, but it should not be done without further evaluation and diagnosis by a specialist. Laboratory tests and chest radiograph may be part of the evaluation, but they are not the most important action.

Question 2

A patient reports chronic nasal obstruction and difficulty distinguishing smells. The provider examines the nares with a nasal speculum and observes several grapelike lesions in both nostrils. What is the likely cause of this patient's symptoms?

A) Chronic sinusitis
B) Nasal polyps
C) Squamous cell carcinoma
D) Vascular benign tumor

B

Accepted Answer

The grapelike lesions are likely nasal polyps, which can cause chronic nasal obstruction and anosmia (loss of smell). Chronic sinusitis may cause nasal obstruction, but would not typically present with grapelike lesions. Squamous cell carcinoma and vascular tumors would present with different visual characteristics and would be unlikely to cause chronic nasal obstruction and loss of smell.

Question 3

A patient reports chronic nasal obstruction and recurrent epistaxis. Which type of nasal mass is likely?&#10;A) Inverted papilloma&#10;B) Nasal polyp&#10;C) Paranasal lymphoma&#10;D) Squamous cell carcinoma

Accepted Answer

Chronic nasal obstruction and recurrent epistaxis are common symptoms of inverted papilloma. Nasal polyps can also cause nasal obstruction, but they do not typically cause epistaxis. Paranasal lymphoma and squamous cell carcinoma may cause nasal obstruction, but they are not typically associated with recurrent epistaxis.

Deck 76: Tumors and Polyps of the Nose