Rhinology
Case Scenario # 1 (Deviated nasal septum and similar conditions )
A 25yrs male in OPD with long standing history of Rt. Sided nasal blockage for past 6-7 years. This
blockage is worst when pt. has any Upper respiratory tract infection. On examination you find there is
deviation of nasal septum towards right side along with left sided inferior hypertrophy with pale boggy
mucosa.
a)
b)
c)
d)
e)
Discuss the possible differentials
What is the most likely diagnosis
What is the pathophysiology of the given disease
How will you investigate such a condition
What treatment options are available for such a disease
Case Scenario # 2 (Allergic Polyps , Allergic Fungal polyposis, Antrochoanal Polyp, Allergic Rhinitis)
A 35yrs old house wife comes to OPD with complaints of bilateral nasal blockage which is intermittent in
nature for past many years but now has become worst and continuous for past 4 months. She is also
troubled that she cannot smell the spices during cooking. Examination reveals whitish pale grape like
swellings in both nasal cavity while septum appears normal.
a)
b)
c)
d)
e)
Discuss list of differentials
What is the likely diagnosis
What is the pathophysiology of the given disease
How will you investigate such a case
What treatment options are available
Case Scenario # 3 (Epistaxis, Angiofibroma )
A 14yr old boy brought to E.R by his family with h/o severe nasal bleed for a day, Mother informs you
that the boy has been experiencing on and off nasal bleed in past 6 months. Currently pt. is bleeding and
examination is not possible.
a)
b)
c)
d)
e)
What differential come to your mind please discuss
What could be the likely diagnosis
What is the pathophysiology of the disease
How will you investigate such a case
What would be the treatment in the E.R and subsequent management of this patient
Rhinology
Case Scenario #4 (Acute & Chronic Sinusitis, Rhinosinusitis)
A 38yr old executive is referred to you by neurology with history of on and off headaches especial on the
frontal area for past 6 weeks, pt. also has ipsilateral facial pain and nasal blockage for 2 weeks. On
Anterior Rhinoscopy there is bilateral nasal purulent discharge with postnasal drip.
a)
b)
c)
d)
e)
Discuss list of differentials
What is the likely diagnosis
What is the pathophysiology if the disease
How will you investigate this patient
What treatment options are available
Case Scenario #5 (Foreign body nasal cavity, Rhinolith, Choanal Atresia)
A 4years old is brought to the OPD by his mother with left sided nasal blockage for 6 weeks and foul
smelling discharge with fever for 1 week. On examination there is diffuse mucosal edema and anatomy
could not be appreciated.
a)
b)
c)
d)
e)
Discuss list of differentails
What is the likely diagnosis
What is the pathophysiology of the given disease
How will you investigate this patient
What treatment options are available