Blocked nose Flashcards
what are the types of rhinitis
infective and non-infective
what causes infective rhinitis
rhinosinusitis - viral
types of non-infective rhinitis
allergic
non-allergic
types of allergic rhinitis
intermittent rhinitis
persistent rhinitis
causes of non-allergic rhinitis
idiopathic rhinitis (vasomotor) polyps
what is idiopathic rhinitis
parasympathetic overdrive (blocks the nose)
management of idiopathic rhinitis
ipratropium - anticholinergic
what are polyps
like asthma but polyps in the nose
what 3 conditions are linked / crossover
asthma
allergic rhinitis
nasal polyps
functions of the nose
smell
cleans and warms the air
immune system
symptoms of allergic rhinitis
rhinorrhoea sneezing nasal blockage itch (can also get inferior turbinate hypertrophy not just polyps)
symptoms usually switch from side to side, true or false
true
unless there is a physical obstruction
what guidelines are used in allergic rhinitis
ARIA guidelines
allergic rhinitis has a strong genetic drive, true or false
true
how do you diagnosis allergic rhinitis
2 or more of: watery rhinorrhoea, sneezing, nasal obstruction, itch +- conjunctivitis
demonstration of allergen specific IgE
post nasal drip
what do mast cells release
histamine - causes sneezing
leukotrienes - cause more blockage
drugs for allergic rhinitis
steroids anti histamines leukotriene receptor antagonist immunotherapy omalizumab
what antihistamines are used
citirazine, loratidine - non sedating
chlorphenamine - sedating
H1 receptor antagonists
example of leukotriene antagonist
montelukast
how do steroids work
act on nuclear receptors
dont work immediately
why doesnt everyone just get steroids
many side effects
immunosuppression, bones, skin, muscles, thrush…
examples of steroids
beclomethasone BD - bigger systemic bioavailability - becanase
fluticasone - flixonase
mometasone - masonex
causes of persistent allergic rhinits aka perennial
dogs, cats, house dust mites
causes of intermittent allergic rhinitis aka seasonal
pollens - grass and tree
rarely flowers
allergic crease
line across nose seen in patient with allergic rhinitis
investigations for allergic rhinitis
skin prick tests RAST - blood test peak nasal inspiratory flow PEFR smell testing rhinomanometry / spirometry
history taking
fixed block or switches side
block vary or persistent
examine nose
what do people usually mistake inferior turbinates for
nasal polyps
4 main allergens
mites
dogs and cats
pollen
moulds
how can you reduce exposure to house dust mite allergens
mattress and pillow covers wash sheets at 60' remove carpet damp dusting modern vacuum cleaner
steroids target blocked nose, true or false
true
antihistamines are for itch, true or false
true
