Allergic Rhinitis Study Guide

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a common trigger for perennial allergic rhinitis?

Certain foods

Chemical fumes

House dust mites (correct)

Pollen from trees

How is episodic allergic rhinitis defined?

Chronic symptoms year-round

Exposure to allergens on a sporadic basis (correct)

Symptoms affecting daily activities

Symptoms present for more than a month

What is the duration criterion for persistent allergic rhinitis?

Symptoms occurring less than 10 times a year

Symptoms present only in spring

More than 4 days per week for 1 month (correct)

Less than 4 days per week for 1 month

Mild allergic rhinitis is characterized by an impact on which of the following?

No impact on quality of life Signup and view all the answers

Which of the following is a major pathogenic mechanism for allergic rhinitis?

Increased IgE antibody production Signup and view all the answers

What happens when pollen enters the nose in the context of allergic rhinitis?

It gets picked up by a dendritic cell Signup and view all the answers

The activation of T cells in allergic rhinitis leads to the production of which substances?

Cytokines Signup and view all the answers

What is the role of IgE antibodies in allergic rhinitis?

To bind to mast cells and trigger responses Signup and view all the answers

What causes the sneezing reflex in allergic rhinitis?

Histamine irritation of the sensory nerve Signup and view all the answers

What major role do leukotrienes play in allergic rhinitis?

Contributing to nasal mucosal swelling Signup and view all the answers

Which of the following is NOT a symptom of allergic rhinitis?

Fever Signup and view all the answers

What is the aim of treatment for allergic rhinitis?

Alleviation of symptoms and daily living difficulties Signup and view all the answers

Which test is used to diagnose allergic rhinitis?

Skin prick test for allergen-specific IgE Signup and view all the answers

What should be done if there is no improvement in symptoms after 5 days of treatment?

Refer to a doctor for other therapy Signup and view all the answers

What effect does histamine have on blood capillaries during an allergic reaction?

Causes dilation and leakage Signup and view all the answers

What specific symptoms are required for a definite diagnosis of allergic rhinitis?

Sneezing, nasal itching, and nasal blockage Signup and view all the answers

What is Azelastine primarily used for?

Nasal spray for allergic rhinitis Signup and view all the answers

When should treatment with Azelastine begin for optimal results?

2–3 weeks before the hay fever season starts Signup and view all the answers

What is a potential side effect of prolonged use of topical decongestants?

Increased nasal congestion Signup and view all the answers

Which combination is beneficial for treating intermittent eye symptoms?

Eye drops containing an antihistamine and decongestant Signup and view all the answers

What is allergic rhinitis primarily characterized by?

Inflammatory process of the nasal mucosa Signup and view all the answers

What should be noted about the use of steroid nasal sprays?

Their effects are maximized with regular use. Signup and view all the answers

Which demographic should avoid using steroid nasal sprays?

Pregnant women Signup and view all the answers

Which of the following is a common symptom of allergic rhinitis?

Nasal discharge and sneezing Signup and view all the answers

What effect do decongestants generally have on nasal congestion?

They provide short-term relief Signup and view all the answers

What is the duration criteria for the symptoms of allergic rhinitis?

Symptoms persisting for at least one hour a day for two consecutive days Signup and view all the answers

What advice should be given to patients using Azelastine nasal spray?

Keep the head upright during use Signup and view all the answers

Which of the following classifications of allergic rhinitis is NOT recognized?

Chronic allergic rhinitis Signup and view all the answers

What is the major cause of allergic rhinitis symptoms?

Inflammatory response to allergens Signup and view all the answers

Which allergens are commonly associated with seasonal allergic rhinitis?

Grass pollens and tree pollens Signup and view all the answers

Why is timely diagnosis of allergic rhinitis important?

It ensures correct management based on guidelines. Signup and view all the answers

What impact does allergic rhinitis have on affected individuals?

It is a major cause of absenteeism in school and work. Signup and view all the answers

What is the role of communication with patients in pharmacotherapy management?

It improves patient satisfaction and quality of life. Signup and view all the answers

Which of the following antihistamines is considered a first-generation antihistamine?

Chlorpheniramine Signup and view all the answers

What type of antihistamines are primarily recommended for patients with mild to moderate intermittent symptoms?

Second-generation antihistamines Signup and view all the answers

For pet allergies, what is the recommended action?

Avoid contact with causative pets. Signup and view all the answers

What is an effective method to reduce dust mites in the home?

Using a dehumidifier. Signup and view all the answers

What characteristics are common with first-generation antihistamines?

They cause more sedation compared to second-generation antihistamines. Signup and view all the answers

How should treatment choices be made for allergic rhinitis patients?

Based rationally on symptoms and patient history. Signup and view all the answers

Which scenario indicates that a patient may need to see a doctor for allergic rhinitis?

Symptoms do not respond to OTC treatment. Signup and view all the answers

What characteristic is true about nasal steroids?

They are effective only at the site of administration. Signup and view all the answers

What is a key feature of Sodium Cromoglycate?

It should be started well in advance of the hay fever season. Signup and view all the answers

Which of the following is an adverse effect of Sodium Cromoglycate?

Nasal irritation Signup and view all the answers

How should Cromoglycate eye drops be administered for optimal effectiveness?

Four times a day continuously. Signup and view all the answers

What advice should be given to drivers during high pollen concentration?

Keep windows and air vents closed. Signup and view all the answers

What is the primary purpose of using Sodium Cromoglycate as a treatment?

To stabilize mast cells and prevent symptoms. Signup and view all the answers

When should patients consider seeking referral for allergic rhinitis?

When there is persistent nasal blockage. Signup and view all the answers

Which of the following is NOT commonly recommended for managing allergic rhinitis?

Infrequent use of treatments. Signup and view all the answers

Study Notes

Allergic Rhinitis (AR)

AR is an inflammatory process of the nasal mucosa, typically IgE-mediated, elicited by environmental allergens.
Symptoms include nasal discharge, nasal itching, sneezing, and nasal obstruction.
The disease course involves symptoms lasting at least an hour a day for at least two consecutive days, and is reversible spontaneously or with treatment.

Common Causes of Allergic Rhinitis

Dust mites
Dust and pollen
Molds
Pets
Foods and beverages
Airborne irritants

Pathogenic Mechanisms of Allergic Rhinitis

Allergens trigger an inflammatory response involving the release of histamine.
Dendritic cells capture allergens and present them to T cells.
Activated T cells stimulate B cells to produce IgE antibodies.
IgE antibodies bind to mast cells, releasing histamine.
Histamine causes blood vessel dilation, increased fluid, and immune cell recruitment.
Nasal mucosal swelling and irritation leads to symptoms like sneezing and rhinorrhea.

Classifications of Allergic Rhinitis

According to Etiology

Seasonal allergic rhinitis (hay fever)
Perennial allergic rhinitis
Episodic allergic rhinitis (EAR)

According to Duration

Intermittent allergic rhinitis (symptoms less than 4 days/week or less than a month/year)
Persistent allergic rhinitis (symptoms for ≥ 4 days/week and ≥ 1 month/year)
Symptoms are also classified as either mild, moderate, or severe, based on the impact on daily activities, school/work attendance, sleep, and need for therapy.

Diagnosis of Allergic Rhinitis

Three key symptoms: sneezing, nasal itching, watery rhinorrhea, and nasal blockage.
Positive nasal eosinophil tests
Identifying causative allergens through skin reactions or serum allergen-specific IgE antibody measurements .

Treatment Timescale

Improvement should be expected within a few days.
If no improvement after 5 days, the patient should be referred for further evaluation and treatment.

Aim of Treatment

Alleviate symptoms and remove everyday life difficulties.
Treatment choice based on severity, disease type, and lifestyle.

Management of Allergic Rhinitis

Non-Pharmacological Treatment

Combinations of pharmacotherapies tailored to severity, and patient communication.
Elimination and avoidance of antigens.
Lowering humidity with dehumidifiers to reduce dust mites.
Avoidance of pets and keeping pets clean in patients with pet allergies.

Pharmacological Treatment

Options include antihistamines, nasal steroids, and mast cell stabilizers.
OTC antihistamines / steroid nasal sprays are effective for mild and moderate cases.
Prescription-level medications may be involved in severe or more persistent cases.

Antihistamines

First-generation: can be effective but can cause sedation.
Second-generation: less sedating, effective for hay fever.

Topical antihistamines

Azelastine nasal spray is a good choice for mild and intermittent cases.
Treatment is best introduced 2-3 weeks before hay fever season.

Decongestants

Oral and topical decongestants can help with nasal congestion.
Topical decongestants should be used for no more than a week due to a risk of rebound congestion.

Steroid nasal sprays

Beclomethasone and fluticasone nasal sprays are effective for moderate to severe symptoms.
Regular use is essential for long term effects.
Should not be recommended for pregnant women or those with glaucoma.

Mast cell stabilizers

Sodium cromoglycate can be effective in managing symptoms (prophylactic).
Two-week prolonged administration is needed for sufficient clinical effects.

Further Advice

Close car windows during pollen season.
Maintain household cleanliness to minimize dust mites.

When to Refer

Wheezing/shortness of breath
Tightness of chest
Painful ear
Painful sinuses
Purulent conjunctivitis
Failed medication response

Learning Objectives (from provided text)

Know what is allergic rhinitis.
Define what common cause of allergic rhinitis.
Identify Pathogenic mechanisms of allergic rhinitis.
Know classification of allergic rhinitis.
Define how to manage allergic rhinitis.
Define trigger points indicative for referral.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Explore the key concepts of Allergic Rhinitis (AR), including its causes, symptoms, and underlying mechanisms. This quiz will help reinforce your understanding of the inflammatory response triggered by various allergens and the body's subsequent reaction. Perfect for students studying immunology or related fields.