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A - MSRA ENT [6] > [17] Allergic Rhinitis > Flashcards

[17] Allergic Rhinitis Flashcards

1
Q

What is allergic rhinitis?

A

Inflammation of the nose that occurs when the immune system overreacts to allergens in the air

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2
Q

How can allergic rhinitis be further categorised?

A
  • Seasonal allergic rhinitis
  • Perennial rhinitis
  • Occupational rhinitis
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3
Q

When does seasonal allergic rhinitis occur?

A

Only at certain times of the year

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4
Q

If seasonal allergic rhinitis is due to pollen or grass what is it known as?

A

Hay fever

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5
Q

When does perennial rhinitis occur?

A

Throughout the year

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6
Q

What are some common allergens in perennial rhinitis?

A
  • House dust mites

- Domestic pets

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7
Q

What causes occupational rhinitis?

A

Exposure to allergens at work

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8
Q

What occupational allergens can cause rhinitis?

A
  • Flour
  • Wood dust
  • Latex
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9
Q

What immunoglobulin mediates allergic rhinitis?

A

IgE

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10
Q

What does IgE cause in response to allergen exposure?

A

Release of inflammatory mediators from mast cells in the nasal mucosa leading to migration of inflammatory cells

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11
Q

What is the most important inflammatory mediator in allergic rhinitis?

A

Histamine

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12
Q

Does allergic rhinitis have a genetic or environmental underlying cause?

A

Mixture of factors

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13
Q

What are the risk factors for allergic rhinitis?

A
  • History of atopy
  • Family history of atopy
  • Exposure to common allergens
  • Air pollution
  • Reduced exposure to infection
  • Exposure to cigarette smoke
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14
Q

What are the typical symptoms of allergic rhinitis?

A
  • Sneezing
  • Rhinorrhoea and nasal congestion
  • Itchy nose and/or palate
  • Eye symptoms
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15
Q

What colour is the rhinirrhoea usually in allergic rhinitis?

A

Clear

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16
Q

What does yellow rhinorrhoea suggest?

A

Allergy or infection

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17
Q

What does green rhinorrhoea suggest?

A

Infection

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18
Q

What does blood tinged rhinorrhoea raise concern of?

A

Tumour

19
Q

Is rhinorrhoea in allergic rhinitis bilateral or unilateral?

A

Bilateral

20
Q

What are the eye symptoms of allergic rhinitis?

A
  • Watering
  • Itching
  • Redness
  • Swelling
21
Q

How is allergic rhinitis usually diagnosed?

A

Clinically

22
Q

What additional test may be helpful in determining the causative allergen in allergic rhinitis?

A

Allergy testing

23
Q

What allergy testing methods are used in allergic rhinitis?

A
  • Skin prick testing

- Blood assays

24
Q

What are the advantages of skin prick testing?

A
  • Reliable

- Immediate results

25
Q

What can suppress response and obscure results of skin prick testing?

A
  • Antihistamines
  • Topical corticosteroids
  • TCAs
26
Q

What is involved in allergy testing blood assays for allergic rhinitis?

A

Total allergen-specific IgE concentrations are determined

27
Q

What are the differentials for allergic rhinitis?

A
  • Non-allergic rhinitis
  • Infective rhinitis
  • Nasal polyps
  • Sinusitis
  • Adenoidal hypertrophy
  • CF
  • SLE
  • Granulomatous conditions
28
Q

What are the main lines of treatment for allergic rhinitis?

A
  • Education
  • Allergen avoidance
  • Anti-histamines
  • Topical steroids
29
Q

What are the first line ‘as-required’ treatments for allergic rhinitis?

A

Nasal anti-histamines

30
Q

What are the advantages of nasal anti-histamines in treating allergic rhinitis?

A
  • Equal efficacy to oral anti-histamines for treating rhinitis symptoms
  • Fast acting (less than 15 minutes)
31
Q

What is the disadvantage of nasal histamines in treating allergic rhinitis?

A

Do not reduce symptoms at other sites unlike oral anti-histamines

32
Q

Who should nasal anti-histamines not be used in for allergic rhinitis?

A

Under 5’s

33
Q

When are oral anti-histamines advised in allergic rhinitis?

A

When sneezing or nasal discharge are predominant and regular preventer therapy is required

34
Q

What types of oral anti-histamines are recommended in allergic rhinitis?

A

Once-daily, non sedating

35
Q

Give an example of a once-daily, non-sedating anti-histamine?

A

Cetirizine

36
Q

When are topical intranasal steroids more useful than anti-histamine for treating allergic rhinitis?

A

When nasal blockage is predominant or polyps are present

37
Q

What symptoms of allergic rhinitis are intranasal steroids effective at treating?

A

All symptoms

38
Q

Are intranasal steroids faster or slower in onset than anti-histamines?

A

Slower

39
Q

How long may intranasal steroids take to develop maximum efficacy when used to treat allergic rhinitis?

A

Days to weeks

40
Q

When may surgery be an indicated treatment for allergic rhinitis?

A

When drugs fail and structural abnormalities are present

41
Q

What surgeries may improve the airway or entry of topical medications in allergic rhinitis?

A
  • Reduction of inferior turbinates

- Correction of deviated septum

42
Q

What does immunotherapy for allergic rhinitis involve?

A

Exposure to increasing amounts of allergens to develop tolerance

43
Q

What are the complications of allergic rhinitis?

A
  • Poor quality of life
  • Poor asthma control
  • Sinusitis
  • Nasal polyps
  • Chronic otitis media

A - MSRA ENT [6] (22 decks)

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