Allergic rhinits

Question 1

what is allergic rhinitis?

Answer 1

An IgE-mediated immunologic response of nasal mucosa to airborne allergens, characterized by watery nasal discharge, nasal obstruction, sneezing, and itching.

Question 2

What are the two clinical types of allergic rhinitis?

Answer 2

1. Seasonal: Symptoms appear in specific seasons due to pollens.
2. Perennial: Symptoms are present year-round.

Question 3

aetiology?

Answer 3

Inhalant Allergens

Seasonal: Tree, grass, weed pollens.
Perennial: Molds, dust mites, cockroaches, animal dander.
Genetic Predisposition

Children’s risk: 20% (one parent) to 47% (both parents with allergy).

Question 4

What is the acute phase of allergic rhinitis?

Answer 4

Occurs 5–30 minutes after allergen exposure, characterized by sneezing, rhinorrhoea, and nasal blockage due to histamine release.

Question 5

What is the late phase of allergic rhinitis?

Answer 5

Occurs 2–8 hours after exposure, involves eosinophil and other inflammatory cell infiltration, causing swelling and thick secretion.

Question 6

What is the “priming effect” in allergic rhinitis?

Answer 6

Sensitized mucosa reacts to smaller doses of allergens and other non-specific antigens.

Question 7

What are the cardinal symptoms of seasonal allergic rhinitis?

Answer 7

Paroxysmal sneezing, nasal obstruction, watery discharge, and itching in the nose, eyes, palate, or pharynx.

Question 8

What are the symptoms of perennial allergic rhinitis?

Answer 8

Frequent colds, persistent stuffy nose, loss of smell, postnasal drip, chronic cough, and hearing impairment.

Question 9

What are some nasal signs of allergic rhinitis?

Answer 9

Transverse nasal crease, pale mucosa, swollen turbinates, watery or mucoid discharge, allergic salute (the gesture of wiping nose upwardly)

Question 10

What are ocular signs of allergic rhinitis?

Answer 10

Lid oedema, conjunctival congestion, and dark circles under the eyes. (allergic shinner)

Question 11

What are otologic signs of allergic rhinitis?

Answer 11

Retracted tympanic membrane and serous otitis media.

Question 12

What are pharyngeal signs of allergic rhinitis?

Answer 12

Granular pharyngitis and signs of prolonged mouth breathing.

Question 13

What are laryngeal signs of allergic rhinitis?

Answer 13

Hoarseness and oedema of the vocal cords.

Question 14

What is the ARIA classification for allergic rhinitis?

Answer 14

Classification based on duration (intermittent or persistent) and severity (mild, moderate, severe).

Question 15

What investigations are used for diagnosing allergic rhinitis?

Answer 15

Total and differential leukocyte count (TLC or DLC), nasal smear, skin tests
(SKIN PRICK TEST &IgE in-vitro), specific IgE measurements, RAST( radio-allergo sorbent test we just measure which allergen causes igE increase), and nasal provocation test.

Question 16

RAST test?

Answer 16

RAST( radio-allergo sorbent test we just measure which allergen causes igE increase)

Question 17

What are some complications of allergic rhinitis?

Answer 17

Recurrent sinusitis, nasal polyps, serous otitis media, orthodontic problems, and increased risk of bronchial asthma.

Question 18

What are the main treatment options for allergic rhinitis?

Answer 18

Avoidance of allergen, drug treatments, and immunotherapy.

Question 19

What are the types of drugs used to treat allergic rhinitis?

Answer 19

Antihistamines, sympathomimetics (alpha-2 agaonists), corticosteroids, sodium cromoglycate (mast-cel stabilizer), anticholinergics, leukotriene receptor antagonists, and anti-IgE.

Question 20

drug treatments

Answer 20

Antihistamines: Control sneezing, itching, and discharge.
Sympathomimetics: Reduce congestion.
Corticosteroids: Effective for severe symptoms, short-term use.
Sodium Cromoglycate: Mast cell stabilizer.
Anticholinergics: Control rhinorrhoea.
Leukotriene Receptor Antagonists: Block leukotriene receptors.
Anti-IgE: Reduces IgE levels, used for asthma.

Question 21

What is immunotherapy for allergic rhinitis?

Answer 21

Gradual exposure to increasing doses of allergen to build tolerance, often administered subcutaneously, sublingually, or nasally.

Question 22

What is the step-care approach recommended by ARIA?

Answer 22

Mild Intermittent: Oral antihistamines or intranasal cromolyn.
Moderate: Intranasal corticosteroids.
Severe: Combination of antihistamines and steroids.
Persistent Severe: Oral steroids and immunotherapy.
Nasal Obstruction: Short-term decongestants.

Question 23

What is nonallergic rhinitis and how does it relate to allergic rhinitis?

Answer 23

Nonallergic rhinitis can coexist with allergic rhinitis and is caused by nonspecific stimuli that trigger similar symptoms due to nasal mucosa hyper-reactivity.