Term
| What are the key clinical features of sinusitis? |
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Definition
Symptoms:
Facial pain/swelling (cheeks, eyes, forehead).
Nasal congestion, anosmia (loss of smell), purulent nasal discharge.
Fever (if bacterial).
Headache worsened by bending forward.
Duration: Acute (<4 weeks) vs. chronic (>12 weeks).
Triggers: Viral/bacterial infection, allergies, anatomical abnormalities (e.g., deviated septum).
Why this matters: Differentiates sinusitis from migraines or tension headaches, which lack nasal symptoms. |
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Term
| How would you differentiate sinusitis from a common cold? |
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Definition
Sinusitis:
Persistent symptoms >10 days.
Facial pain/pressure, purulent discharge.
Fever (more common in bacterial cases).
Common cold:
Symptoms resolve within 7–10 days.
Clear nasal discharge, sneezing, sore throat.
Why this matters: Guides appropriate use of antibiotics (not needed for viral colds). |
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Term
| What red flags suggest bacterial sinusitis requiring antibiotics? |
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Definition
“Double sickening”: Worsening after initial improvement.
Severe symptoms:
Fever >38°C, unilateral facial pain.
Purulent discharge with unilateral predominance.
Duration: Symptoms >10 days without improvement.
Why this matters: Identifies cases needing antibiotics (e.g., amoxicillin) to prevent complications like orbital cellulitis. |
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Term
| What first-line management would you recommend for viral sinusitis? |
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Definition
Conservative measures:
Saline nasal irrigation (e.g., Neti pot).
Steam inhalation.
Hydration and rest.
Symptomatic relief:
Paracetamol/ibuprofen for pain/fever.
Decongestant sprays (≤7 days to avoid rebound congestion).
Intranasal corticosteroids (e.g., fluticasone) for inflammation.
Why this matters: Avoids unnecessary antibiotics and addresses inflammation/blockage. |
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Term
| When would you prescribe antihistamines for sinusitis? |
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Definition
Indication: Suspected allergic component (e.g., seasonal rhinitis, known allergies).
Examples: Loratadine or cetirizine.
Caution: Avoid sedating antihistamines (e.g., diphenhydramine) in daytime.
Why this matters: Reduces allergic mucosal swelling but is ineffective for non-allergic sinusitis. |
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Term
| How would you advise a patient on using saline nasal rinses? |
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Definition
Technique: Use sterile/distilled water to avoid infection risk.
Frequency: 2–3 times daily during acute episodes.
Benefits: Clears mucus, reduces congestion, and improves steroid spray efficacy.
Why this matters: Improves symptom relief and prevents complications like nasal crusting. |
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Term
| What lifestyle modifications help prevent recurrent sinusitis? |
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Definition
Avoid triggers: Allergens (dust, pollen), smoking, dry air.
Humidification: Use a humidifier in dry environments.
Hydration: Maintain fluid intake to thin mucus.
Vaccination: Annual flu vaccine to reduce viral triggers.
Why this matters: Addresses modifiable risk factors (e.g., smoking, allergies). |
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Term
| What complications can arise from untreated bacterial sinusitis? |
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Definition
Local spread: Orbital cellulitis, osteomyelitis.
Intracranial: Meningitis, brain abscess.
Chronicity: Persistent inflammation leading to nasal polyps.
Why this matters: Emphasizes the importance of timely antibiotic use in high-risk cases. |
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Term
| How would you respond to a patient demanding antibiotics for sinusitis? |
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Definition
Explain: “Most cases are viral and antibiotics won’t help. Let’s focus on symptom relief.”
Safety-netting: “If symptoms worsen or persist beyond 10 days, we’ll reconsider antibiotics.”
Shared decision-making: Discuss risks of antibiotic resistance.
Why this matters: PLAB 2 prioritizes antimicrobial stewardship and patient education. |
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Term
| What ENT examination findings support a sinusitis diagnosis? |
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Definition
Anterior rhinoscopy: Purulent discharge, mucosal erythema.
Palpation: Tenderness over sinuses (frontal/maxillary).
Transillumination: Diminished light transmission in affected sinuses (less reliable).
Why this matters: Objective findings strengthen clinical diagnosis and justify management. |
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Term
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Definition
Use structured history-taking: Clarify duration, discharge color, and facial pain patterns.
Safety-netting: “Return if you develop vision changes, severe swelling, or high fever.”
Empathy: “I understand sinus pain can be exhausting. Let’s work on relieving it safely.”
These cards emphasize clinical differentiation, evidence-based management, and patient communication—critical for exam success. |
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