Allergic Rhinitis

Question 1

What is rhinitis?

Answer 1

Inflammation of the nasal mucosa

Question 2

What is allergic rhinitis?

Answer 2

Inflammatory response of the upper airway triggered by allergens

Question 3

What is the pathophysiology of allergic rhinitis?

Answer 3

Exposure to environmental allergens = allergic sensitisation

Production of IgE -> mast cell activation

• stimulation of mucous glands
• sensory nerve stimulation
• vasodilation

Question 4

What are risk factors for developing allergic rhinitis?

Answer 4

FHx of atopy
<20
Western lifestyle
Inadequate exposure to animals as a child

Question 5

What are the symptoms of allergic rhinitis?

Answer 5

Sneezing 
Nose itching 
Eye itching + redness
Nasal congestion 
Rhinorrhoea

Question 6

How is allergic rhinitis investigated?

Answer 6

Therapeutic trial of antihistamine or intranasal corticosteroid

Question 7

How is mild allergic rhinitis managed?

Answer 7

Oral/intranasal antihistamine

Question 8

How is moderate allergic rhinitis managed?

Answer 8

Oral antihistamine

Intranasal corticosteroid

Question 9

How is severe allergic rhinitis managed?

Answer 9

Intranasal corticosteroid

Question 10

What patient advice should be given

Answer 10

Allergen avoidance

• keep doors/windows shut
• wear sunglasses

Question 11

How should allergic rhinitis patients be followed up?

Answer 11

2 weeks for intranasal corticosteroid

Stepped down as necessary