ENT - Allergy

Question 1

What are some risk factors for allergic rhinitis?

Answer 1

• Heredity: atopy
• Infectious diseases
• Pollution
• Exposure to:
  Flour / Latex / Wood / Dust

Question 2

What are some syndromes often associated with allergic rhinitis?

Answer 2

• Asthma

- Atopic dermatitis

Question 3

What are some symptoms of allergic rhinitis?

Answer 3

• Sneezing / itch / blockage
• Rhinorrhoea
  Severe:
• Chronic obstruction
• Hyposmia
• Hyperreactivity

Question 4

What is a Type 1 / Immediate Hypersensitivity Reaction?

Answer 4

1. Sensitization: Plasma cells produce IgE, binds mast cells

2. Re-exposure: mast cells degranulate, Release Histamine, Leukotrienes, Prostaglandins & chomotactic factors

Question 5

What type of hypersensitivty reaction is alleric rhinitis? describe pathophysiology?

Answer 5

Type 1 Hypersensitivity

1. Phase 1: degranulation causing systemic effects, such as vasodilation, mucous secretion, nerve stimulation and smooth muscle contraction
2. Phase 2: migration of other leukocytes such as neutrophils, lymphocytes, eosinophils and macrophages to the initial site

Question 6

What are some of the effects of a type 1 hypersensitivity reaction? (How does it present)

Answer 6

• Sneezing
• Coughing
• Wheezing
• Runny nose
• Watery eyes
• itching

Question 7

What is allergic rhinitis? What causes it?

Answer 7

• allergic inflammation of the nasal airways

- Occurs when allergen is inhaled by an individual with a sensitized immune system

Question 8

What investigations can be done to diagnose allergic rhinitis?

Answer 8

1. Skin Prick Test: hypersensitivity test (up to 15% false positives)
2. RAST Allergy Blood Test: presence of allergen specific IgE

• Total Serum IgE
• Nasal Allergen Challenge
• Nasal Cytology

Question 9

How is allergic rhinitis treated?

Answer 9

• Allergen avoidance by patient

Pharmacological:
    Topical Intranasal steroids
    Systemic Steroids
    Antihistamines
    Sodium Cromoglycate
    Allergen Immunotherapy
    Anti-IgE

Question 10

How is allergic rhinitis diagnosed?

Answer 10

Timing:

• Intermittent (< 4 days / week or < 4 consecutive weeks)
• Persistent

Severity:

• Mild
• Moderate-Severe (sleep / daily activity disturbance)