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HEENT > Allergic Rhinitis > Flashcards

Allergic Rhinitis Flashcards

1
Q

State the type of rhinitis:

Disease caused by an IgE mediated inflammatory response of the nasal mucous membranes after exposure to inhaled allergens. Symptoms include: Rhinorrhea, nasal congestion, nasal itching, and sneezing

A

Allergic rhinitis

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2
Q

State the type of rhinitis:

Disease caused by an IgE mediated inflammatory response to seasonal aeroallergens. Length of exposure is dependent on geographic location and climatic conditions

A

Seasonal Allergic rhinitis

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3
Q

State the type of rhinitis:

Disease caused by an IgE mediated inflammatory response to year-round environmental aeroallergens. Including dust mites, mould, animal allergens or occupational allergens

A

perennial allergic rhinitis

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4
Q

State the type of rhinitis:

Disease caused by an IgE mediated inflammatory response and characterized by persistent symptoms >4days per week and >4 weeks per year

A

persistent allergic rhinitis

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5
Q

State the type of rhinitis:

Disease caused by an IgE mediated inflammatory response that can occur if an individual is in contact with an exposure that is not normally a part of the individual’s environment (ex. cat at friend’s house)

A

episodic allergic rhinitis

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6
Q

Symptoms of allergic rhinitis

A

sneezing, nasal congestion, nasal itching, rhinorrhea, eye redness can also be present

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7
Q

What is allergic rhinitis caused by?

A

IgE - mediated reactions to inhaled allergens

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8
Q

what two conditions is allergic rhinitis linked to?

A

asthma and conjunctivitis

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9
Q

What three conditions coexist in individuals due to shared genetic conditions?

A

allergic rhinitis, asthma, atopic dermatitis

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10
Q

How long are symptoms for intermittent allergic rhinitis?

A

< 4 days/week or <4 consecutive weeks

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11
Q

How long are symptoms for persistent allergic rhinitis?

A

> 4 days/week or >4 consecutive weeks

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12
Q

A patient is having some symptoms of allergic rhinitis but has normal sleep, no impairment of daily activities, sports, and leisure. Normal work days. Is this considered mild or moderate-severe rhinitis?

A

mild allergic rhinitis

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13
Q

what classification of allergic rhinitis consists of abnormal sleep, impairment of daily activities, sport, leisure, and problems at work and school.

A

moderate-severe allergic rhinitis

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14
Q

What is the term called when the body produced IgE antibodies due to genetic and/or environmental factors?

A

Atopy

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15
Q

T or F: allergic rhinitis is considered a localized disorder

A

False: part of the respiratory tract now

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16
Q

What cells take up the allergens in the nasal mucosa during allergic rhinitis?

a) mast cells
b) basal cells
c) dendritic cells
d) epithelial cells

A

c) dendritic cells

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17
Q

List some risk factors associated with allergic rhinitis?

A 
concomitant asthma 
family history of atopy 
ethnic origin other than white european 
antibiotic use 
maternal and paternal smoking 
early introduction of food or formula 
no older siblings 
allergen exposure 
pollutants 
higher socio economic class 
heavy alcohol consumption
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18
Q

What types of medication cause symptoms of allergic rhinitis?

A 
beta-blockers, 
ASA, NSAIDS, 
ACE inhibitors
hormone therapy 
cocaine
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19
Q

What are some visible signs of allergic rhinitis in kids?

A

mouth breathing
rubbing at nose
sniffling or throat clearing
dark circles under eyes bc of nasal congestion

20
Q

T or F: allergic rhinitis is easily diagnosed in primary care

A

False: often undetected in primary care

21
Q

What test is used to identify specific allergic triggers of rhinitis

A

Skin prick testing

22
Q

Which specific drug does not appear to reduce skin test reactivity?

A

Montelukast

23
Q

List 3 general factors that can affect the quality of the allergen extract

A

Age, seasonal variations, drugs

24
Q

List 4 classes of therapeutic options

A
  1. education
  2. allergen avoidance
  3. pharmacotherapy
  4. allergen immunotherapy
25
Q 
List the general steps a patient usually takes when having rhinitis or asthma symptoms
1.
2. 
3. 
4. 
5.
A
  1. self-care
  2. pharmacist
  3. general practitioner
  4. specialist
  5. Emergency Care
26
Q

Group the order of medications in order when a patient has allergies
(leukotriene receptor antagonists,
combination intranasal corticosteroid/ antihistamine spray,
allergen avoidance
oral antihistamines
intranasal corticosteroids
allergen immunotherapy

A
  1. allergen avoidance
  2. oral antihistamines
  3. intranasal corticosteroids
  4. combo intranasal corticosteroid and antihistamine spray
  5. leukotriene reeptor antagonists
  6. allergen immunotherapy
27
Q

Tips for allergen avoidance

A

keep window closed
using screen filters
using an air conditioner
limit time outdoors

28
Q

oral antihistamines _________ action of histamine by acting as neutral receptor _________ of histamine H1 receptor

A

oral antihistamines BLOCK action of histamine by acting as neutral receptor ANTAGONIST of the histamine H1 receptor.

They do not prevent release of histamine

29
Q

List 2 non-sedating 2nd antihistamines

A
  1. fexofenadine

2. bilastine

30
Q

Pros of oral antihistamines?

Cons of oral antihistamines?r

A

Pros: once-daily administration, rapid/effective action, low cost
Cons: less effective than intranasal corticosteroids, some sedation experienced, limited penetration of the BBB

31
Q

Which receptor do oral and intranasal antihistamines target?

A

H1 receptor

32
Q

Pros and cons of intranasal antihistamines?

A

Pros: rapid onset of action, first or second line of action
Cons: bitter taste, epistaxis, headache, somnolence, nasal burning
Intranasal > oral antihistamine for nasal congestion

33
Q

How long does it take to reach the peak effect when taking intranasal corticosteroids?

A

several hours to days

34
Q

What symptoms do intranasal corticosteroids improve?

A

sneezing, itching, rhinorrhea, congestion

35
Q

Which intranasal corticosteroid can improve allergic eye symptoms?

A

fluticasone furoate

36
Q

What are some adverse effects of intranasal corticosteroids

A

nasal dryness, burning, stinging, blood-tinged secretions, and epistaxis

37
Q

What should a patient be monitoring for when taking intranasal corticosteroid?

A

intraocular pressure, glaucoma, cataracts

38
Q

What are some ADRs of the combo spray dymista?

A

bitter taste, epistaxis, somnolence, headache

39
Q

How long should you use an intranasal corticosteroid/intranasal oxymetazoline combination?

A

less than 3 days (short term) bc pt can develop rhinitis medicmentosa

40
Q

What cells produce leukotrienes?

A

mast cells, eosinophils, basophils, macrophages, and monocytes

41
Q

When should leukotriene receptor antagonists be used?

A

only be used if antihistamines, intranasal corticosteroids, or combo are not tolerated

42
Q

ADR of using leukotriene receptor antagonists

A

Upper respiratory tract infection and headache

43
Q

What are some cons to taking intranasal cromolyn?

A

slow onset of action (4-7 days)
1 spray in each nostril 6 times daily
slight irritation of the mucosa

44
Q

Should oral/intranasal decongestants be avoided in pregnancy?

A

yes

45
Q

Role of anticholinergics?

A

block cholinergic receptors to decrease watery nasal secretions

46
Q

What are some side effects of ipratropium nasal spray? (Atrovent)

A

nasal and oral dryness, irritation and burning

HEENT (14 decks)

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