Allergic Rhinitis (Exam 3) Flashcards
Rhinitis
Inflammatory response in nasal passages to allergens
atopic allergic disease
how is allergic rhinitis initiated? and what happens?
initiated by exposure of nasal mucosa to airborne antigens
evokes IgE production
what is released due to allergic rhinitis
histamine
leukotrienes
B4, C4, D4, E4
prostaglandins
kinins
kininogen
serotonin
is rhinitis and allergic rhinitis the same?
No!
allergic rhinitis
induction of rhinitis symptoms after allergen exposure by an IgE mediated immune reaction
symptoms of rhinitis
itching
nasal discharge
sneezing
nasal airway obstruction
common forms of rhinitis
allergic
infectious
non-allergic
non allergic with eosinophilia syndrome (NARES)
chronic rhino sinusitis with/without poylps
chronic rhino sinusitis with/without poylps
hypertrophic, inflammatory disorder that can affect allergic/non allergic individuals
drug induced rhinitis
aspirin
some vasodilators
less common forms of rhinitis
occupational
drug induced
hormonal
food induced
cold air induced
atrophic
non allergic, non infectious rhinitis
poorly defined
non inflammatory (sensorineural hyper responsiveness, hyperesthesia, dysautonomia)
local allergic reaction
mucus
slippery polymeric aqueous secretion produced by mucous membranes
mucus is secreted from ___________ which contain ________________
mixed glands
both serous and mucous glands
mucus is a
viscous colloid
mucus contains
inorganic salts
antimicrobial enzymes
immunoglobulins
glycoproteins
mucus is produced by
goblet cells in the mucous membranes and submucosal glands
mucus is one of the body’s _______________ of defense systems
first line
deep sneezing
released trapped microbes
if one side of the nose is congested,
air passes through the open nostril (decongested side)
when one nostril is congested, does it stay congested?
no!
sides alternate between being wide open and narrowed
patients must experience at least __________ symptoms for an _________________ on most days to be diagnosed with allergic rhinitis
two
hour or more
symptoms of allergic rhinitis
unusual sensation in the nose/watery eyes
nasal itching
sneezing
runny nose
obstruction in the nasal passage
antihistamines for allergic rhinitis
class 1-3 H1 antagonists
olopantadine
azelastine
decongestants for allergic rhinitis
phenylephrine
naphazoline
oxymetazoline
pseudoephedrine
corticosteroids for allergic rhinitis
beclomethasone
budesonide
flunisolide
mometasone
fluticasone
triamcinolone
leukotriene antagonists for allergic rhinitis
montelukast
ARIA classification
intermittent
persistent
mild
moderate to severe
intermittent ARIA classification
less than four days
less than 4 weeks
persistent ARIA classification
over 4 days/week
more than 4 weeks
mild ARIA classification
normal sleep
no impairment of daily activities
no troublesome symptoms
moderate severe
abnormal sleep
impairment of daily activities
troublesome symptoms
guidelines of ARIA is on the basis of
duration of intermittent/persistent disease
severity of symptoms and quality of life as mild/moderate severe
primary diagnosis of allergic rhinitis
detailed personal/family allergic history
intranasal examination - anterior rhinos copy
allergic skin tests and/or in vitro specific IgE tests
secondary diagnosis of allergic rhinitis
nasal secretion/scraping cytology
nasal allergen challenge
nasal endoscopy
CT scan
what type of test is used for allergic rhinitis
allergy skin prick testing (right positive result)
possible management of allergic rhinitis
avoiding the substance that triggers the allergy
nasal corticosteroid sprays
antihistamines
saltwater solution
desensitization injections
do antibiotics relieve symptoms of allergic rhinitis?
NO
is asthma considered a genetic disease?
NO
have not been validated
genetic variants in _________________ are most widely studied and have been associated with altered therapeutic response to ________________
ALOX5 and LTC4S
asthma drugs
allergen immunotherapy (allergy shots)
form of long term treatment that decreases symptoms
decreases sensitivity to allergens
allergen immunotherapy is used with many people with
allergic rhinitis, allergic asthma, conjunctivitis or stinging insect allergy
omalizumab
binds to Fc portion of IgE
used for asthma or chronic idiopathic urticaria
cerebrospinal rhinorrhea
trigger - sinus/facial manipulation
testing - otolaryngology
symptoms - clear nasal discharge after sinus surgery/trauma; symptoms worsen
gustatory
feature - socially debilitating
triggers - spicy foods, alcohol
symptoms - rhinitis associated with food consumption
nonallergic with eosinophilia syndrome
feature - treated as vasomotor rhinitis
testing - specific allergen testing is negative, nasal cellular infiltrate is full of eosinophils
symptoms - persistent rhinitis symptoms
atrophic rhinitis
symptoms - atrophy of nasal mucosa resulting in ozena
testing - culture for culprit bacteria, nutritional deficiency
triggers - dry environment, surgery
occupational rhinitis
symptoms - rhinitis symptoms at work, but improve at home
trigger - allergic/non allergic
features - asthma/conjunctivitis
testing - evaluation for IgE testing
aspirin allergy may likely have association with
asthma and nasal polyps
