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EN4.{21-26,28-29} | Nose Airway and Rhinitis Disorders — Assignment

Grading Rubric — Nose Airway and Rhinitis Disorders — Assignment Rubric

Criterion	Points	Full-marks descriptor
EN4.21, EN4.22, EN4.28 — Nasal Obstruction, DNS, and Epistaxis: Clinical Reasoning	8 pts	Exceeds: Correctly classifies nasal polyp type (ethmoidal vs antrochoanal) with laterality; accurately names Little's area for anterior epistaxis and Woodruff's plexus for posterior epistaxis with their vessel contributions; gives a logical differential for unilateral nasal obstruction including JNA (with do-not-biopsy rule); explains septoplasty vs SMR distinction with rationale
EN4.24, EN4.25, EN4.26 — Rhinitis Differential Diagnosis and Management	6 pts	Exceeds: Correctly distinguishes allergic rhinitis (positive SPT/IgE, eosinophilia on smear), vasomotor rhinitis (negative SPT/IgE, no eosinophilia, non-immunological triggers), NARES (eosinophilia, negative SPT), and hypertrophic rhinitis (non-shrinking turbinates); correct first-line for each (INCS, trigger avoidance, ipratropium, turbinate surgery respectively)
EN4.23, EN4.29 — Adenoids and Obstructive Sleep Apnea	4 pts	Exceeds: States adenoidectomy indications accurately (nasal obstruction with mouth breathing, recurrent OME, recurrent adenoiditis); correctly names polysomnography as the gold standard for OSA with AHI grading (mild 5–14, moderate 15–29, severe ≥30); names CPAP as first-line for moderate-severe OSA
Quality of Clinical Reasoning and Communication	2 pts	Exceeds: Responses are logically structured, clinically precise, and use appropriate ENT terminology; case-based reasoning flows from history → examination → investigation → management