Rhinitis

Question 1

Presentation of allergic rhinitis

Answer 1

• 2 or more of the following symptoms for >1hr on most days
  
  • Watery anterior rhinorrhea
  • Sneezing, especially paroxysmal
  • Nasal obstruction
  • Nasal pruritis
  • Conjunctivitis
• Intranasal signs:
  
  • Pale, oedematous (and therefore enlarged) turbinates
  • Nasal congestion
  • Clear discharge
• Causes include:
  
  • Animals
  • Pollen
• Not associated with:
  
  • Unilateral symptoms
  • Nasal obstruction without other symptoms
  • Mucopurulent rhinorrhea
  • Posterior rhinorrhea (post nasal drip)
  • Pain
  • Recurrent epistaxis
  • Anosmia

Question 2

Management of allergic rhinitis

Answer 2

Question 3

Causes of non-allergic rhinitis

Answer 3

• Causes include:
  
  • Air pollutants
  • Odours
  • Smoke
  • Food
  • Alcohol
  • Medication
  • Weather changes

Question 4

Management of non-allergic rhinitis

Answer 4

• Saline douching/spray
• Trigger avoidance
• Nasal steroids

Question 5

Rhinitis medicamentosa

Answer 5

• Rebound nasal congestion due to decongestant nasal sprays
• Xylometazoline HCl/Oxylometazoline HCl/phenylephrine sprays for 7 days then stop