Rhinitis Lecture Powerpoint

Question 1

Rhinitis

Answer 1

Presence of one or more of the following nasal symptoms including sneezing, rhinorrhea, nasal congestion, and nasal itching

Question 2

Nasal/occular itching and prominent sneezing is a hallmark of what type of rhinitis?

Answer 2

Allergic

Question 3

Clinical findings of allergic rhinitis (3)

Answer 3

• Allergic shiners
• allergic salute/transverse nasal crease
• pale boggy mucosa sometimes with cobblstoning

Question 4

Proper administration of nasal sprays

Answer 4

Point directly up and back into the nose and let it sit within the nostril (don’t swallow or let drip out)

Question 5

Nonallergic rhinitis with eosinophilia syndrome (NARES)

Answer 5

A localized allergic response (despite the name) with paroxysmal exacerbations that can be a cause of rhinitis where eosinophilia is present 5-20% of the nasal secretion

Question 6

Common triggers of non allergic rhinitis (4)

Answer 6

• tobacco smoke
• changes in temp (vasomotor rhinitis)
• cleaning products and fragrances
• gustatory rhinitis (hot or spicy foods vagal mediated reflex)

Question 7

Rhinitis medicamentosa

Answer 7

Rebound congestion upon cessation of a medication as it wears off (most commonly an OTC decongestant nasal spray) sometimes resulting in return to use, can cause polyp formation or septal erosion

Question 8

1 elicit drug associated with septal perforation and rhinitis medicamentosa

Answer 8

Cocaine

Question 9

Some systemic medications that induce rhinitis (3)

Answer 9

• antihypertensives (B blockers esp.)
• NSAIDS
• estrogens and progesterone (birth control)

Question 10

Hormonal rhinitis

Answer 10

Rhinitis for the last 6 weeks or more of pregnancy without other signs of respiratory tract infection or allergic cause and often disappears within weeks of delivery, can sometimes also fluctuate with menstrual cycle or puberty

Question 11

Hormonal rhinitis mechanism of action theory

Answer 11

Increased level of hormone such as estrogen leads to vascular smooth muscle relaxation, pooling of blood in venous sinuses, and increased plasma leakage

Question 12

Atrophic rhinitis

Answer 12

Occurs in older adults who have undergone repeated sinus and nasal surgeries***, normal with aging to have mild thinning of nasal mucosa but exaggerated and progressive can lead to colonization with bacteria resulting in congestion, crusting, and persistent bad smell

Question 13

Atrophic rhinitis treatment options (2)

Answer 13

• daily nasal lavage

- lubrication combined with topical antibiotics

Question 14

Systemic diseases that can cause rhinitis (3)

Answer 14

• granulomatosis with polyangitis (wegeners)
• sarcoidosis
• cystic fibrosis

Question 15

Structural sources that can cause rhinitis (3)

Answer 15

• congenital abnormalities
• CSF leakage
• tumors (may present unilaterally)***

Question 16

Easy way to differentiate leaking CSF from mucus

Answer 16

Glucose strip