Question 1

A provider determines that a patient has chronic rhinosinusitis without nasal polyps. What is the first-line treatment for this condition?&#10;A) Intranasal corticosteroids&#10;B) Oral decongestants&#10;C) Systemic corticosteroids&#10;D) Topical decongestants

Accepted Answer

Intranasal corticosteroids are the first-line treatment for chronic rhinosinusitis without nasal polyps, as they effectively reduce nasal inflammation and improve symptoms such as congestion, nasal discharge, and facial pain/pressure. Oral decongestants may provide short-term relief but are not recommended for long-term use due to potential side effects. Systemic corticosteroids may be used in severe cases but are not recommended for long-term use due to potential side effects. Topical decongestants should be avoided due to the risk of rebound congestion and potential adverse effects such as increased blood pressure and heart rate.

Question 2

A patient reports persistent nasal blockage, nasal discharge, and facial pain lasting on the right side for the past 5 months. There is no history of sneezing or eye involvement. The patient has a history of seasonal allergies and takes a non-sedating antihistamine. What does the provider suspect is the cause of these symptoms?

A) Allergic rhinitis
B) Autoimmune vasculitides
C) Chronic rhinosinusitis
D) Rhinitis medicamentosa

C

Accepted Answer

The patient's symptoms are indicative of chronic rhinosinusitis, which is characterized by persistent nasal obstruction, nasal discharge, and facial pain lasting for more than 12 weeks. The lack of sneezing and eye involvement suggests that this is not due to allergic rhinitis. Autoimmune vasculitides and rhinitis medicamentosa are less likely causes in this case.

Question 3

A pregnant woman develops nasal congestion with chronic nasal discharge. What is the recommended treatment for this patient?&#10;A) Intranasal corticosteroids&#10;B) Prophylactic antibiotics&#10;C) Saline lavage&#10;D) Topical decongestants

Accepted Answer

Saline lavage is the recommended treatment for nasal congestion and chronic nasal discharge in pregnant women as it is a safe and effective way to relieve symptoms without the use of medication. Intranasal corticosteroids and topical decongestants may have potential risks to the developing fetus and are not recommended unless the benefits outweigh the risks. Prophylactic antibiotics are also not recommended as they can lead to antibiotic resistance and have no proven benefit in this situation.

Deck 70: Chronic Nasal Congestion and Discharge