Rhinitis Flashcards
What is rhinitis?
Inflammation of the lining (mucosa) of the nose
What is the clinical definition of rhinitis?
symptoms of runny nose, sneezing and nasal blockage.
What are the 3 classifications of Rhinitis?
Non-allergic including rhinitis medicamentosa
Infective
Allergic
non-allergic pathogenesis
Occupational - low molecular weight compounds
Drug misuse - cocaine
Hormonal changes - pregnancy and menopause
Idiopathic - cold or dry air
Age
other - food, emotional
Medicines - aspirin, NSAIDs, beta-blockers, antidepressants, oral contraceptives
What are the causes of Rhinitis Medicamentosa?
Chronic overuse of topic decongestants such as xylometazoline (Otrovine products) or oxymetazoline
What are the symptoms of Rhinitis medicamentosa
nasal hypersensitivity, mucosal swelling, rebound nasal congestion
Management of Rhinitis medicamentosa
Withdraw vasoconstrictor nose drops
use topical corticosteroid
patient education
infective rhinitis - acute examples
common cold (viral), influenza, erysipelas
Acute rhinitis - duration and management
Duration 5-10 days
Management - self limiting
infective rhinitis - chronic examples
TB, Leprosy
Bacterial - streptococcal, pneumococcal and staphylococcal
Infective rhinitis - additional symptoms and management
crust formation, foul odour.
Management - nasal swab and culture. Suitable antibiotic
What is allergic rhinitis?
Symptomatic disorder of the nose resulting from an IgE-mediated immunological reaction following exposure to allergen.
Allergic Rhinitis Classification - Seasonal Pollinosis or Hay-Fever
Symptoms peaking during the months of spring and summer when pollen levels are their highest
Allergic Rhinitis Classification - Perennial Rhinitis
Similar to hay fever but substances which cause allergic reaction present all year round.
Inflammatory Process - Immediate Rhinitis Symptoms
Histamines, leukotrienes, prostaglandins, bradykinin and platelet activating factors
- Itch, sneezing, rhinorrhoea, nasal congestion
Inflammatory Process - Chronic rhinitis symptoms
Eosinophils
- Nasal blockage, loss of sense of smell, nasal hyper reactivity
How many L of air does the nose filter, warm and humidify per day?
10,000
What part of the nervous system are nasal passages regulated by?
Sympathomimetic nervous system
Particle size - allergic rhinitis
greater than 10 microns caught in the nose, less than 2 microns in the lungs
Where do wind borne pollens come from 20-30 microns
Spring - trees, hazel and birch
Summer - grasses, flowers, weeds
Fungal spores 2-5 microns got to lungs
house dust mites - perennial AR
Symptoms of hay fever
- sneezing
- coughing
- runny or blocked nose
- itchy red or watery eyes
- loss of smell
- pain around the temples and forehead
- headache
- earache
- feeling tired
Diagnosis tests for rhinitis
- take full patient history
- examination
- skin prick test
- blood eosinophils
- nasal smear
Differential Diagnosis
- timing of rhinitis
- family history - eczema, asthma, urticarial, rhinitis
- living conditions - bedding, carpets, age of house, dampness
- Medications
- Diet
