Nose & Sinuses: Rhinitis

Question 1

Your patient presents with bluish color under their eyes (shiners), rhinorrhea, itchy/watery eyes, clear and watery discharge. Dx?

Answer 1

Allergic Rhinitis

Question 2

Your patient presents with mild/moderate congestion, with clear rhinorrhea. Dx?

Answer 2

Viral Rhinitis

Question 3

Patient is 70 years old and complains of stuffiness, rhinorrhea, and boggy mucosa. Dx?

Answer 3

Vasomotor Rhinitis

Question 4

Patient presents with rhinorrhea, congestion, and opaque discharge. Dx?

Answer 4

Bacterial Rhinitis

Question 5

Patient presents with severe congestion & pain. She has minimal discharge. Dx?

Answer 5

Medicamentosa Rhinitis

Question 6

How do you treat allergic rhinitis?

Answer 6

Avoid irritant. Intranasal steroid, 2nd generation antihistamine. Cromlyn NS for children/pregnant women

Question 7

How do you treat viral rhinitis?

Answer 7

Nasal saline, caution with oral decongestants

Question 8

How do you treat Vasomotor rhinitis?

Answer 8

Fluticasone NS or ipratropium NS. Antihistamines won’t help!

Question 9

How do you treat Bacterial Rhinitis? What normally causes it?

Answer 9

S. pneumonia, H. influenza, M. catarrhalis.

Lasting more than 7 days treat like otitis media (AMOX)

Question 10

How do you treat Medicamentosa rhinitis?

Answer 10

Discontinue irritant. Can be very uncomfrotable for the patient. Can use topical steroids.