5 - ENT - Rhinology - Rhinosinusitis - Allergic and non-allergic RS

Question 1

Allergic RS - when?

Answer 1

can be seasonal (hay fever) or perennial

Question 2

Allergic RS - what happens

Answer 2

IgE mediated infl - pollen (seasonal), house dust mite (perennial)

Question 3

Allergic RS - Sx

Answer 3

sneezing, pruritis, rhinorrhoea - perennial RS gives more nose related symptoms and less pruritis

Question 4

Allergic RS signs

Answer 4

swollen turbinates with pale/mauve mucosa, skin allergy tests may be +ve

Question 5

Allergic RS - mgmt

Answer 5

Antihistamines - use 2nd gen

nasal steroid spray

Question 6

non-allergic RS - - what happens

Answer 6

chronic watery rhinorrhoea - maybe ass w obstruction, sneezing

Question 7

non-allergic RS - 5 dif types

Answer 7

vasomotor RS
occupational RS
hormonal RS
drug induced RS
non-allergic RS with eosinophilia syndrome NARES

Question 8

Vasomotor RS

Answer 8

parasympathetic dominance - triggers include temp change, stress, chemical irritants

Question 9

occupational RS - irritants

Answer 9

include..

latex, wood dust, metal salts, animal dander

Question 10

hormonal RS due to?

Answer 10

increase oestrogen - preg, menstruation, puberty, hormonal meds

Question 11

drug induced RS - what drugs

Answer 11

anti-HTn, NSAIDs, OCP, long term decongestants

Question 12

NARES - describe

Answer 12

Sx same with allergic rhinitis - BUT no atopy demonstrated by allergen skin testing - and >20% eosinophils on nasal cytology - anosmia common (rare in allergic)