Allergic rhinitis

Question 1

Allergic rhinitis - overview

Answer 1

1. Up to 20% of the population affected
2. Symptoms (5) = nasal congestion, itching + sneezing, discharge. May have hx atopy. Record hx of environmental exposures = parental smoking, pets, dust mites, stuffed toys, carpet. bedding
3. Examination (5) = mouth breathing, cough, nose-rubbing, suborbital venous congestion, watery-red eyes
4. Ix = skin tests for specific antigens; specific serum IgE measurements
5. Tx (5)
   - Allergen avoidance = dust covers on bedding, avoid stuffed toys
   - Symptom relief = antihistamines, montelukast (leukotriene receptor antagonist, also used in asthma), intranasal steroids