INSTRUCTIONS Allergic rhinitis: Diagnosis through management
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Allergic rhinitis: Diagnosis through management
General Purpose: The purpose of this learning activity is to provide information about the pathophysiology, diagnosis, and treatment of AR. Learning Objectives: After reading this article and taking this test, you should be able to: 1. Explain the pathophysiology of AR. 2. Describe the clinical presentation, assessment, and diagnostic testing for AR. 3. Select evidence-based treatment approaches for AR.
- AR is
- caused by repeated exposure to histamines.
- an abnormal immunologic response.
- mediated by immunoglobulin G.
- a hypersensitivity disorder of the entire respiratory system.
- An atopic patient
- has no allergies.
- can exhibit an immune response.
- has developed a skin rash.
- can suppress an immune response to allergens.
- are released by stimulated mast cells.
- constitute an early phase response in AR.
- cause a cessation of symptoms.
- inhibit the action of eosinophils.
- Which statement accurately differentiates SAR from PAR?
- Patients with SAR are more likely to experience symptom relief by keeping pets out of the bedroom.
- Dust mites are more likely to cause SAR.
- Patients with PAR are often more symptomatic outdoors.
- SAR is more often associated with the release of pollens.
- When assessing for AR, which of the following is the least relevant finding in the patient history?
- exposure to respiratory irritants
- age of onset of symptoms
- deficiencies associated with smell
- environmental conditions
- Physical exam of the patient with AR reveals
- infraorbital lightening of the skin.
- enlarged inferior turbinates and clear watery discharge.
- a reddened cobblestone appearance of the inferior turbinates.
- ruddy nasal mucosa.
- Which statement about acute infectious rhinosinusitis is true?
- A common symptom is purulent nasal discharge.
- Bacterial rhinosinusitis symptoms resolve in 7–10 days.
- Viral upper respiratory infection symptoms persist beyond 10 days.
- It is usually caused by bacteria.
- Which total serum IgE level is most suggestive of an allergy?
- 10 units/mL
- 50 units/mL
- 100 units/mL
- 480 units/mL
- Skin testing for AR
- is the least sensitive diagnostic methodology.
- can be performed I.using a histamine solution.
- causes the antigen to bind to the surface of mast cells and release histamine.
- causes leukocytes to releases leukotrienes.
- During RAST testing,
- a local skin reaction confirms allergen sensitivity.
- nasal swabs are examined for presence of leukocytes.
- serum is incubated with tagged antibodies of suspected antigens.
- allergen sensitivity is indicated by the presence of serum eosinophils.
- Which of the following is among the most problematic allergens in the home?
- synthetic fibers
- Which is a second-generation oral antihistamine?
- Which statement about topical nasal antihistamines is accurate?
- They are less effective than oral antihistamines.
- They have a slow onset of action.
- They have a fast onset of action.
- They provide poor control of sneezing.
- Topical decongestants can cause
- bradycardia and sedation.
- increased blood flow to nasal vascular tissue.
- Cromolyn sodium
- is prescribed orally once a day.
- is more effective in reducing allergic symptoms than antihistamines.
- has a long half-life.
- is a mast cell stabilizer with limited efficacy.
- When corticosteroids are used for symptoms of AR,
- they are only effective for treating nasal decongestion.
- they cannot be given parenterally.
- topical use results in a high incidence of significant adverse reactions.
- topical application is often used as primary first-line therapy.
- Ipratropium bromide
- is used to relieve nasal congestion.
- is a topical anticholinergic that reduces the volume of rhinorrhea.
- inhibits the release of histamine in patients with AR.
- can be converted into methamphetamine.