Asthma/ Allergic Rhinitis

Question 1

Allergic Rhinitis may be differentiated from the common cold by the following feature

Answer 1

prominent itching and sneezing

Question 2

Produced when the tongue is placed against the roof of the mouth to form a seal and withdrawn rapidly in an effort to scratch the palate

Answer 2

allergic cluck

Question 3

EARLY PHASE response of IgE-mediated immune response is characterized by the following,

Answer 3

> Mast cell degranulation
Associated with sneezing, itching and/or wheezing that usually resolves within 1-3 hours
Associated with increased local vascular permeability and tissue swelling

Question 4

Examination of the posterior pharynx of a patient with moderate or chronic allergic rhinitis may reveal

Answer 4

Cobblestoning

Question 5

True regarding allergen exposure avoidance in patients with allergic rhinitis and asthma

Answer 5

HEPA filters are helpful in reducing the amount of airborne cat allergens
It takes 6 mo or more for the levels of cat allergen to drop to a level found in houses without a cat. As a result, cat owners who remove their pets from their homes should be informed not to expect immediate results.
Exposure to indoor mold allergens can be reduced by maintaining the indoor relative humidity at <50%, removing contaminated carpets, and wiping down washable surfaces prone to fungal growth, such as shower stalls, shower curtains, sinks, drip trays, and garbage pails, with the use of solutions of detergent and 5% bleach

Question 6

True regarding antihistamines in the treatment of Allergic Rhinitis

Answer 6

hepatic dysfunction and certain drugs like macrolide antibiotics may affect clearance

Question 7

Complication of AR may include

Answer 7

Chronic Sinusitis
Bronchial Asthma exacerbation
Allergic conjunctivitis

Question 8

Intranasal decongestants like oxymetazoline are known to cause rebound nasal congestion with prolonged use. Thus the recommendation is:

Answer 8

not repeated more than once a month and not more than 3-5 days use

Question 9

Cause of recurrent cough in children that may be misdiagnosed as asthma

Answer 9

Chronic sinusitis
GERD
Vocal Cord Dysfunction
Aspiration

Question 10

RELIEVER medications for asthma exacerbation

Answer 10

Oral corticosteroids
inhaled salbutamol
Inhaled Formoterol
Inhaled anti-cholinergics

Question 11

Radiographs of patients with asthma exacerbation may show

Answer 11

Normal chest X-ray
Hyperinflation
Peribronchial thickening

Question 12

Diurnal variation in peak of expiratory flow (PEF) _____ is consistent with Asthma

Answer 12

> 20%

Question 13

patient in asthma exacerbation who sits upright, talks in words and with a paCO2 of >42cmH2O is considered to have

Answer 13

Severe exacerbation

Question 14

Early childhood MAJOR risk factors for persistent asthma includes

Answer 14

Parental asthma
eczema
Inhalant allergen sensitization

Question 15

Sneezy, 4yrs old, was brought to the clinic because of recurrent cough. The mother claims he has been presenting with dry-productive cough especially upon waking up in the morning, occurring 4 days/week. There is no history of fever, but the patient has on and off watery rhinorrhea that started last March. No medication was given because the colds would spontaneously resolve within the day. However, he was noted to have recurrent bouts of cough in the morning, sometimes accompanied by sneezing. He can sleep well at night and plays without limitation of activity. Sneezy has no previous admission/ER visit due to DOB. The mother has bronchial asthma. She tried nebulization with SABA with minimal improvement of cough. What is the likely problem of the patient

Answer 15

Allergic Rhinitis, mild persistent