Atrophic Rhinitis

Atrophic Rhinitis

Q. 1

A female presented with long standing nasal obstruction. She also complaints about comments from her friends telling about foul smell coming from her nose which she could not recognise. On evaluation, atrophic rhinitis is diagnosed. What can be the etiology in this patient to develop secondary atrophic rhinitis?

 A

Chronic sinusitis

 B

Nasal trauma

 C

Oropharyngeal cancer

 D

Strong hereditary factors

Q. 1

A female presented with long standing nasal obstruction. She also complaints about comments from her friends telling about foul smell coming from her nose which she could not recognise. On evaluation, atrophic rhinitis is diagnosed. What can be the etiology in this patient to develop secondary atrophic rhinitis?

 A

Chronic sinusitis

 B

Nasal trauma

 C

Oropharyngeal cancer

 D

Strong hereditary factors

Ans. A

Explanation:

Specific infections like syphilis, lupus, leprosy, and rhinoscleroma may cause destruction of the nasal structures leading to atrophic changes.

Atrophic rhinitis can also result from long-standing purulent sinusitis, radiotherapy to nose or excessive surgical removal of turbinates.

Extreme deviation of nasal septum may be accompanied by atrophic rhinitis on the wider side. 

 

Q. 2

A 45 year old diabetic patient comes with complaints of hoarseness of voice which temporarily improves on coughing and removal of crusts. On examination, atrophic laryngeal mucosa covered with foul smelling crusts. On removal of crusts, mucosa showed excoriation and bleeding.

Assertion: This is case of atrophic laryngitis, and is associated with atrophic rhinitis.

Reason: Diabetes is the predisposing factor.
 

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Q. 2

A 45 year old diabetic patient comes with complaints of hoarseness of voice which temporarily improves on coughing and removal of crusts. On examination, atrophic laryngeal mucosa covered with foul smelling crusts. On removal of crusts, mucosa showed excoriation and bleeding.

Assertion: This is case of atrophic laryngitis, and is associated with atrophic rhinitis.

Reason: Diabetes is the predisposing factor.
 

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Ans. C

Explanation:

Atrophic laryngitis or Laryngitis sicca is characterized by atrophy of laryngeal mucosa and crust formation.

Condition is often seen in women and is associated with atrophic rhinitis and pharyngitis. Not associated with diabetes.

 

Q. 3

All are implicated in etiology of atrophic rhinitis except:

 A

Chronic sinusitis

 B

Nasal deformity

 C

DNS

 D

Strong hereditary factors

Q. 3

All are implicated in etiology of atrophic rhinitis except:

 A

Chronic sinusitis

 B

Nasal deformity

 C

DNS

 D

Strong hereditary factors

Ans. C

Explanation:

Ans. is c i.e. DNS


Q. 4

Which of the following organisms is known to cause Atrophic Rhinitis:

 A

Klebsiella pneumoniae

 B

Klebsiella ozaenae

 C

Streptococcus pneumoniae

 D

Streptococcus foetidis

Q. 4

Which of the following organisms is known to cause Atrophic Rhinitis:

 A

Klebsiella pneumoniae

 B

Klebsiella ozaenae

 C

Streptococcus pneumoniae

 D

Streptococcus foetidis

Ans. B

Explanation:

 

Organism known to cause atrophic Rhinitis are:

  • Coccobacillus ozaena
  • Diphtheroid bacillus
  • Kiebsiella ozaenae                                                                
  • Bordettela bronchiseptica
  • Pasteurella multocida
  • P. vulgaris
  • E. coli
  • Staphylococcus                                                                    
  • Streptococcus

Q. 5

Cause of nasal obstruction in atrophic rhinitis:

 A

Crusting

 B

Polyp

 C

Secretions

 D

DNS

Q. 5

Cause of nasal obstruction in atrophic rhinitis:

 A

Crusting

 B

Polyp

 C

Secretions

 D

DNS

Ans. A

Explanation:

Q. 6

All are true regarding atrophic rhinitis except:

 A

More common in males

 B

Crusts are seen

 C

Anosmia is noticed

 D

Young’s operation is useful

Q. 6

All are true regarding atrophic rhinitis except:

 A

More common in males

 B

Crusts are seen

 C

Anosmia is noticed

 D

Young’s operation is useful

Ans. A

Explanation:

Q. 7

Merciful anosmia is seen in:

 A

Atrophic rhinitis

 B

Allergic rhinitis

 C

Ethmoidal polyposis

 D

Wegener’s granulomatosis

Q. 7

Merciful anosmia is seen in:

 A

Atrophic rhinitis

 B

Allergic rhinitis

 C

Ethmoidal polyposis

 D

Wegener’s granulomatosis

Ans. A

Explanation:

 

In atrophic rhinitis, there is foul smell from the nose, making the patient a social outcast though the patient himself is unaware of the smell due to marked anosmia which accompanies the degenerative changes. This is called as merciful anosmia.


Q. 8

Regarding atrophic rhinitis, which is INCORRECT:

 A

Common in females

 B

Anosmia

 C

Due to chronic use of nasal drops

 D

None of the above

Q. 8

Regarding atrophic rhinitis, which is INCORRECT:

 A

Common in females

 B

Anosmia

 C

Due to chronic use of nasal drops

 D

None of the above

Ans. C

Explanation:

 

Rhinitis medicamentosa (or RM) is a condition of rebound nasal congestion brought on by extended use of topical decongestants (e.g., oxymetazoline, phenylephrine,xylometazoline, and naphazoline nasal sprays) that work by constricting blood vessels in the lining of the nose.


Q. 9

Young’s operation is done for:           

 March 2013 

 A

Atrophic rhinitis

 B

Vasomotor rhinitis

 C

Antrachonal polyp

 D

Allergic rhinitis

Q. 9

Young’s operation is done for:           

 March 2013 

 A

Atrophic rhinitis

 B

Vasomotor rhinitis

 C

Antrachonal polyp

 D

Allergic rhinitis

Ans. A

Explanation:

Ans. A: Atrophic rhinitis

Young’s operation is a surgery designed for the treatment of atrophic rhinitis.

The surgical procedure involves closure of the nasal cavity affected with atrophic rhinitis by creating mucocutaneous flaps. These flaps are sutured together in two layers: first the mucosal layer, then the skin layer. The nasal cavity is kept closed for a period of 6 months or later; then an examination is done – if the crusts have disappeared, a revision surgery is performed and the nasal cavity is reopened


Q. 10

Which of the following organisms is known to cause Atrophic rhinitis ‑

 A

Klebsiella ozaena

 B

Klebsiella pneumonia

 C

Streptococcus pneumonia

 D

Streptococcus foetidis

Q. 10

Which of the following organisms is known to cause Atrophic rhinitis ‑

 A

Klebsiella ozaena

 B

Klebsiella pneumonia

 C

Streptococcus pneumonia

 D

Streptococcus foetidis

Ans. A

Explanation:

Ans. is ‘a’ i.e., Klebsiella ozaena

Atrophic rhinitis (Ozaena)

Atrophic rhinitis is a chronic inflammation of nose characterized by atrophy of nasal mucosa, including the glands, turbinate bones and the nerve elements. Atrophic rhinitis may be primary or secondary : ‑

1) Primary atrophic rhinitis

The primary pathology is inflammation and atrophy of the nose. Generally, atrophic rhinitis refers to primary atrophic rhinitis. Causes are : –

i) Hereditary

ii) Endocrinal pathology – Starts at puberty. Stops after menopause

iii) Racial factors – Seen more in Whites and Yellow races

iv) Nutritional deficiency – Deficiency of vitamin A, D, E and iron may be responsible for it.

v) Infective – Klebsiella ozanae, Diphtheriods, P. vulgaris, E.coli, Staphylococci, Streptococci.

vi)  Autoimmune process – Causing destruction of nasal, neurovascular and glandular elements may be the cause.

2) Secondary atrophic rhinitis

Specific infections, such as syphilis, lupus, leprosy, and rhinoscleroma, may cause destruction of the nasal structures leading to atrophic changes. Can also results from long standing purulent sinusitis , radiotherapy of nose, excessive surgical removal of the turbinate and as complication of DNS on the root side of nose.

 


Q. 11

Youngs surgery is done for the treatment of ‑

 A

Atrophic rhinitis

 B

Rhinoscleroma

 C

Deviated nasal septum

 D

Choanal atresia

Q. 11

Youngs surgery is done for the treatment of ‑

 A

Atrophic rhinitis

 B

Rhinoscleroma

 C

Deviated nasal septum

 D

Choanal atresia

Ans. A

Explanation:

Ans. is ‘a’ i.e., Atrophic rhinitis

Surgical treatment of Atrophic rhinitis

1) Young’s operation

2) Modified Young’s operation

3) Narrowing of the nasal cavity by (Lautenslagers operation) ‑

4) Lautenslagers operation



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