Info
🌱 來自: Huppert’s Notes
Rhinitis🚧 施工中
Rhinitis
• Physical exam: Inspect the nasal cavities and oropharynx
• Differential diagnosis:
- Allergic rhinitis
• Symptoms: Watery eyes, rhinorrhea, sneezing, congestion, nasal itching, often with identifiable trigger (e.g., pollen)
• Physical exam: Nasal mucosa may be normal, pale blue, or with pallor
• Diagnosis: Clinical diagnosis (no specific labs/imaging required)
• Treatment:
- Topical intranasal glucocorticoid (e.g., fluticasone). Must be used daily to be effective. Warn patients about the risk of dry nose which can cause a bloody nose
- Add a second-generation over-the-counter antihistamine/decongestant if a second line agent is needed
- Recommend avoidance of identifiable triggers if feasible
- Add over-the-counter eye drops for allergic conjunctivitis
- Consider referral to allergy/immunology if no improvement with medical management
- Vasomotor rhinitis (aka nonallergic rhinitis)
• Symptoms: Nasal congestion, postnasal drainage. Symptoms occur throughout the year without a clear trigger.
• Physical exam: Nasal mucosa may be normal or boggy
• Diagnosis: Clinical diagnosis (no specific labs/imaging required)
• Treatment: Topical intranasal antihistamine, glucocorticoids
- Nasal tumors