Which antibody is involved in allergic rhinitis?
What is allergic rhinitis?
a symptomatic disorder of the nose induced after allergen exposure by an IgE-mediated inflammation
(T/F) Allergic rhinitis more commonly affects male adults.
F. adulthood prevalence: males = females
(T/F) Allergic rhinitis more commonly affects male children.
What are the main signs and symptoms of allergic rhinitis?
- Nasal obstruction and congestion
- Nasal itching/pruritus
What are the Ssx of clear rhinorrhea?
chronic postnasal drip, cobblestone throat, frequent throat clearing, itchy throat, non-productive cough
What are the Ssx of nasal congestion?
allergic shiners, pale turbinates, mouth breathing, abnormal facial development, dental malocclusion, snoring, sleep disturbance
What are the Ssx of nasal itching?
facial grimace, allergic salute, nasal crease
Which of the following is false about Dennie-Morgan lines?
A. also known as panda eyes
B. marker for allergy
C. occurs in people with good capillary refill around the eyes
D. occurs in people with frequent nasal congestion
(T/F) The previous classification of allergic rhinitis was based on the time of exposure.
Which of the following is not a classification of AR based on the time of exposure? A. perennial B. occasional C. seasonal D. occupational
What are the bases of the ARIA classification?
- frequency of occurence
2. severity of symptoms
(T/F) AR is considered to have an intermittent frequency when it occurs two days in a week for 3 weeks.
What are the criteria used to determine the severity of AR?
sleep pattern, impairment of daily activities, functioning at work/school, “troublesome” symptoms
(T/F) Allergic rhinitis is a type 2 hypersensitivity reaction.
What are the two phases of a type 1 hypersensitivity reaction?
sensitization phase/elicitation phase
(T/F) IL-4 is secreted by TH2 cells.
What substances are released during mast cell degranulation?
histamine, leukotrienes, cytokines
Which of the three (histamine, leukotrienes, cytokines) is primarily responsible for a late-phase reaction?
(T/F) A late phase reaction may occur several hours after initial exposure to antigen but requires additional exposure.
What are the risk factors for allergic rhinitis?
increasing age, atopy, higher socioeconomic class, family history, positive allergy skin test, pollution, tobacco smoke/indoor allergens, early introduction to food/milk formulas
What are the 4 most common comorbidities of allergic rhinitis?
conjunctivitis, rhinosinusitis, otitis media w/effusion, asthma
(T/F) Conjunctivitis associated with AR is commonly associated with eye discharges.
Which is the most important part of the history in diagnosing AR?
What are the most common indoor aeroallergens according to the PGH allergy clinic?
house dustmite, cockroach
(T/F) ELISA is more sensitive than the skin-prick test in determining whether there is IgE specific hypersensitivity.
What is the gold standard radiological investigation for sino-nasal disorders?
coronal CT scan
What are the components of the four-pronged approach to the management of allergic diseases?
allergen avoidance, pharmacotherapy, immunotherapy, patient education
What are the pharmacologic options for mild intermittent rhinitis?
oral or intranasal antihistamine, intranasal decongestants, antileukotrienes
What are the pharmacologic options for moderate-severe intermittent/mild persistent rhinitis?
oral or intranasal antihistamine, decongestants, antileukotrienes, chromones, intranasal corticosteroids
What are the pharmacologic options for moderate-severe persistent rhinitis?
intranasal corticosteroids as first line, antihistamine or antileukotrienes, chromones
(T/F) asthma is more common among male children
(T/F) Chronic production of sputum in a patient would increase suspicion for asthma.
Which of the following is the most frequently observed respiratory abnormality in asthmatic patients? A. expiratory wheezing B. inspiratory wheezing C. stridor D. rales
What is the normal FEV1/FVC ratio?
> 0.75- 0.80 in healthy adults and >0.90 in children
(T/F) A large bronchodilator reversilbility is supportive evidence for asthma
What is the cut-off in PEF variation that is indicative of asthma?
What are the long-term goals of asthma management?
symptom control, risk reduction
What are the risk factors for asthma exacerbation?
previous asthma intubation, uncontrolled asthma symptoms, >=1 exacerbation in the past year, low FEV1, incorrect inhaler technique, smoking, obesity, pregnancy, blood eosinophilia
What are the risk factors for fixed airflow limitation?
no ICS treatment, smoking, occupational exposure, mucus hypersecretion, eosinophilia
What are the risk factors for asthma medication side-effects?
frequent oral steroids, potent ICS/P450 inhibitors
What is the prevalence rate of allergic rhinitis among asthmatic patients?