N316a Exam 3 Review 2025 Questions and
Answers
Acute Sinusitis - ANS Infection of the sinuses
Often due to URI or allergy
(viral: 5 to 7 days)
(bacterial: up to 4 weeks)
How long does sinusitis have to last for to be considered chronic sinusitis? - ANS more than
12 weeks
Sinusitis S/S - ANS HA, pain over sinus areas, fatigue, nasal obstruction, purulent nasal
discharge
Sinusitis Dx & Tx - ANS Dx: transillumination of the sinuses by pen light
Tx: antimicrobial agents (antibiotics), decongestants, saline sprays, heated mists
Acute Rhinitis - ANS Inflammation and irritation of nasal mucosa (aka: common cold)
* Viral: rhinovirus and other viruses; nasal mucosa and tubrinates are red; yellow or green
discharge, high lymphocyte levels
*Allergies: nasal mucosa & turbinates are gray; clear nasal discharge; eosinophil levels are high
Topical Nasal Decongestants - ANS Decrease the overproduction of secretions by causing
local vasoconstriction to the upper respiratory tracts
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,(used for sinusitis & rhinitis)
* make it easier to breathe
e.g., oxymetazoline (Afrin), Phenylephrine (Coricidin), Tetrahydrozoline (Tyzine),
Xylometazoline (Otrivin)
Actions of Topical Nasal Decongestants - ANS sympathomimetic, affects sympathetic nervous
system to cause vasoconstriction, causing less inflammation and edema of the nasal membrane
Indications: Topical Nasal Decongestants - ANS relieve the discomfort of nasal congestion
that accompanies the common cold (acute rhinitis), sinusitis, and allergic rhinitis
Asthma - ANS - hyperreactive airway disease of bronchioles
- reversible airway constriction
- each attack leads to inflammatory changes (bronchial remodeling)
- different etiologies, multifactorial genetics [allergies (most common), occupational exposure,
viral infections, GERD (especially nocturnal asthma), exercise-induced]
Asthma Classifications: Mild intermittent - ANS - symptoms occur fewer than 2 times a week,
attacks are brief
- FEV1 greater than 80% of normal during asthma attacks
Asthma Classifications: Mild persistent - ANS - symptoms are occurring more than twice a
week, but not as often as daily
- FEV1 greater than or equal to 80% of normal during asthma attacks
Asthma Classifications: Moderate persistent - ANS - daily symptoms, quick-relief inhaler daily
- asthma attacks at least 2x per week
- FEV1: 60% and 80% of normal; FEV1/FVC ratio reduced by 5%
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, Asthma Classifications: Severe persistent - ANS - symptoms are basically continuous
- FEV1 less than 60% of normal
- FEV1/FVC ratio reduced by greater than 5%
What are the two categories of asthma medications? - ANS 1. Maintenance: long-acting
bronchodilators & anti-inflammatory corticosteroids
2. Rescue: short-acting bronchodilators (e.g., albuterol), inhaler used for acute asthma attacks
(acute exacerbation may even need a shot of epi)
Pulmonary Embolism (PE) - ANS - clot that usu starts in the venous system and has traveled
& lodged in pulmonary arterial circulation (e.g., DVT from L.E., atrial thrombus)
- obstruction of blood flow to lung
- presentation is vague, without warning, silent
- can lead to death
PE Tx - ANS anticoagulants, clot buster, inferior vena cava (IVC) filter
PE S/S - ANS severe chest pain, can't breathe
Obstructive Sleep Apnea (OSA) - ANS upper airway closes intermittently during sleep
OSA s/s - ANS loud snoring, choking or gasping during sleep, un-restful sleep, and daytime
sleepiness
OSA risk & exacerbating factors - ANS - obesity is a risk factor
- other risks include nasal blockage, airway anatomy (e.g., large tonsils, deviated septum,
abnormal neck anatomy)
- worsened by alcohol and sedative-hypnotic medications
Pg. 3 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
Answers
Acute Sinusitis - ANS Infection of the sinuses
Often due to URI or allergy
(viral: 5 to 7 days)
(bacterial: up to 4 weeks)
How long does sinusitis have to last for to be considered chronic sinusitis? - ANS more than
12 weeks
Sinusitis S/S - ANS HA, pain over sinus areas, fatigue, nasal obstruction, purulent nasal
discharge
Sinusitis Dx & Tx - ANS Dx: transillumination of the sinuses by pen light
Tx: antimicrobial agents (antibiotics), decongestants, saline sprays, heated mists
Acute Rhinitis - ANS Inflammation and irritation of nasal mucosa (aka: common cold)
* Viral: rhinovirus and other viruses; nasal mucosa and tubrinates are red; yellow or green
discharge, high lymphocyte levels
*Allergies: nasal mucosa & turbinates are gray; clear nasal discharge; eosinophil levels are high
Topical Nasal Decongestants - ANS Decrease the overproduction of secretions by causing
local vasoconstriction to the upper respiratory tracts
Pg. 1 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
,(used for sinusitis & rhinitis)
* make it easier to breathe
e.g., oxymetazoline (Afrin), Phenylephrine (Coricidin), Tetrahydrozoline (Tyzine),
Xylometazoline (Otrivin)
Actions of Topical Nasal Decongestants - ANS sympathomimetic, affects sympathetic nervous
system to cause vasoconstriction, causing less inflammation and edema of the nasal membrane
Indications: Topical Nasal Decongestants - ANS relieve the discomfort of nasal congestion
that accompanies the common cold (acute rhinitis), sinusitis, and allergic rhinitis
Asthma - ANS - hyperreactive airway disease of bronchioles
- reversible airway constriction
- each attack leads to inflammatory changes (bronchial remodeling)
- different etiologies, multifactorial genetics [allergies (most common), occupational exposure,
viral infections, GERD (especially nocturnal asthma), exercise-induced]
Asthma Classifications: Mild intermittent - ANS - symptoms occur fewer than 2 times a week,
attacks are brief
- FEV1 greater than 80% of normal during asthma attacks
Asthma Classifications: Mild persistent - ANS - symptoms are occurring more than twice a
week, but not as often as daily
- FEV1 greater than or equal to 80% of normal during asthma attacks
Asthma Classifications: Moderate persistent - ANS - daily symptoms, quick-relief inhaler daily
- asthma attacks at least 2x per week
- FEV1: 60% and 80% of normal; FEV1/FVC ratio reduced by 5%
Pg. 2 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
, Asthma Classifications: Severe persistent - ANS - symptoms are basically continuous
- FEV1 less than 60% of normal
- FEV1/FVC ratio reduced by greater than 5%
What are the two categories of asthma medications? - ANS 1. Maintenance: long-acting
bronchodilators & anti-inflammatory corticosteroids
2. Rescue: short-acting bronchodilators (e.g., albuterol), inhaler used for acute asthma attacks
(acute exacerbation may even need a shot of epi)
Pulmonary Embolism (PE) - ANS - clot that usu starts in the venous system and has traveled
& lodged in pulmonary arterial circulation (e.g., DVT from L.E., atrial thrombus)
- obstruction of blood flow to lung
- presentation is vague, without warning, silent
- can lead to death
PE Tx - ANS anticoagulants, clot buster, inferior vena cava (IVC) filter
PE S/S - ANS severe chest pain, can't breathe
Obstructive Sleep Apnea (OSA) - ANS upper airway closes intermittently during sleep
OSA s/s - ANS loud snoring, choking or gasping during sleep, un-restful sleep, and daytime
sleepiness
OSA risk & exacerbating factors - ANS - obesity is a risk factor
- other risks include nasal blockage, airway anatomy (e.g., large tonsils, deviated septum,
abnormal neck anatomy)
- worsened by alcohol and sedative-hypnotic medications
Pg. 3 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
