Rhinitis

Question 1

the presence of one or more of: sneezing, rhinorrhea (anterior/posterior), nasal congestion, nasal itching

Answer 1

rhinitis

Question 2

what is the most common form of rhinitis?

Answer 2

allergic rhinitis

Question 3

what is the second common form of rhinitis?

Answer 3

nonallergic rhinitis (NAR)

Question 4

a form of nonallergic rhinitis in older adults who have had repeated sinus and nasal surgeries and now have progressive atrophy of the nasal lining

Answer 4

atrophic rhinitis

Question 5

a patient presents with nasal itching, congestions, watery rhinorrhea, sneezing, poor sleep, snoring, fatigue, headaches, rhinosinusitis, and history of asthma. what is this patient experiencing?

Answer 5

allergic rhinitis

Question 6

what 2 conditions increase risk for allergic rhinitis?

Answer 6

1. co-morbid eczema
2. asthma

Question 7

what are 3 physical findings I should expect to find in a child with allergic rhinitis?

Answer 7

1. allergic shiners
2. allergic salute
3. transverse nasal crease

Question 8

what would an otoscope exam of the nasal mucosa look like if a patient has allergic rhinitis?

Answer 8

1. edematous (swelling)
2. pale

Question 9

70% of patients who have seasonal allergic rhinitis also have _____ _____, which gives symptoms of ___, ___, ___ eyes

Answer 9

allergic conjunctivitis - itchy, red, water eyes

Question 10

what is the management for a patient with allergic rhinitis? list in the correct order (3)

Answer 10

1. allergen avoidance
2. pharmacotherapy
3. allergen immunotherapy

Question 11

what is the first line medication for a patient with allergic rhinitis?

Answer 11

steroid nasal spray

Question 12

what are 2 steroid nasal sprays to use for allergic rhinitis?

Answer 12

1. nasonex
2. flonase

Question 13

what medication do some providers start in children with allergic rhinitis because it is safer?

Answer 13

NasalCrom

Question 14

what is the second line treatment for a patient with allergic rhinitis?

Answer 14

oral antihistamine

Question 15

what are 3 oral antihistamines that can be used as a second line treatment for allergic rhinitis?

Answer 15

1. zyrtec
2. claritin
3. allegra

Question 16

what is the third line treatment for a patient with allergic rhinitis if they do not respond to steroid nasal spray or an oral antihistamine?

Answer 16

nasal antihistamine

Question 17

what are 2 antihistamine nasal sprays that can be used for allergic rhinitis?

Answer 17

1. Astelin
2. Patanase

Question 18

what is the fourth line treatment for patients that have persistent or moderate-to-severe allergic rhinitis?

Answer 18

Montelukast - helps decrease body’s response to allergens

Question 18

what should I recommend to a patient with allergic rhinitis that has not responded to the first, second, or third line treatment?

Answer 18

allergen immunotherapy

Question 18

what are some triggers for NAR? (4)

Answer 18

1. perfumes
2. cleaning products
3. alcoholic beverages
4. newsprint

Question 18

what are two treatments I should give to a patient with allergic conjunctivitis that is present with allergic rhinitis?

Answer 18

1. steroid nasal spray AND
2. antihistamine eye drops

Question 18

what are 3 antihistamine eye drops that I can use for a patient with allergic conjunctivitis that is present with allergic rhinitis?

Answer 18

1. elestat
2. optivar
3. pataday

Question 18

what is an at-home treatment for allergic rhinitis?

Answer 18

irrigation with hypertonic nasal saline

Question 18

NAR reaction to nonspecific irritants - air pollution, temperature changes (cold, dry air)

Answer 18

vasomotor rhinitis

Question 19

a patient presents with nasal congestion, rhinorrhea, and postnasal drainage all year round (perennial) and has a later onset, with the absence of nasal/ocular itching and sneezing. what is this patient experiencing?

Answer 19

non-allergic rhinitis

Question 19

NAR reaction of prominent watery rhinorrhea triggered most often by hot or spicy foods

Answer 19

gustatory rhinitis

Question 20

what are 2 treatments that can help a patient with nonallergic rhinitis manage symptoms?

Answer 20

1. nasal steroid 2. nasal antihistamine

Question 21

what has been approved to treat the symptoms of rhinorrhea in chronic nonallergic rhinitis?

Answer 21

ipratropium nasal spray

Question 22

how would an ENT likely treat a patient with nonallergic rhinitis? (3)

Answer 22

1. oral decongestants (sudafed) 2. nasal lavage / saline spray 3. oral antihistamine