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15 Cards in this Set
- Front
- Back
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What are the primary symptoms of rhinitis?
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External nasal dripping, post-nasal drip, congestion, sneezing.
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What is atopy?
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An inherited tendency to developed IgE-mediated allergic diseases such as rhinitis, asthma, eczema.
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Which of the following is FALSE about late-phase response?
A. Late phase response occurs 4-12 hours after exposure to antigen. B. Late phase response is less intense than early response. C. Late phase response may persist for days to weeks. D. PGD2 is not a part of the late response |
B. Late phase response is less intense than early response.
This is false, can be just as intense. |
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Regarding nasal physiology, the highly vascularized mucosa is under autonomic and pharmacologic control. The sympathetics [ constrict / dilate ] vessels and the parasympathetics [ constrict / dilate ] vessels. Which produces mucin?
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Sympathetics: constrict vessels
Parasympathetics: dilate vessels and produces mucin. |
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An allergic substance contacting a _______________ activates the cell to release mediators.
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presensitized IgE armed mast cell or basophil
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The initial allergic rhinitis reaction is primarily the result of mucosal mast cell degranulation. How does mediator release lead to more diffuse response?
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Mediator releae leads to opening of mucosal intercellular tight junctions, and enhances penetration of antigen to the more numerous submucosal mast cells and basophils multiplying the response.
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Early response mediators include what 4 things? What about the late response?
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EARLY: Histamine, PGD2 (mast cells only), LTC4 (and its metabolites), Bradykinin (basophils primarily).
LATE: all but PGD2 note: PGD2 is not a part of the late response suggesting that mast cells do not take part in the late phase response. Mast cells are not depleted, though as rechallenge with antigen produces another early phase response with PGD2 in nasal secretions. |
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In terms of allergic rhinitis treatment, avoidance and pharmacotherapy are available. What does each do:
A. antihistamines B. Nasal/ oral decongestants : alpha-adrenergic agonists C. Nasal/oral decongestant: Disodium cromoglycate spray |
A. antihistamines - block effects of released histamine by competing for H-1 receptors
B. Nasal/ oral decongestants : alpha-adrenergic agonists - vasconstrictors. May be helpful for a few days but prolonged use --> rhinitis medicamentosa C. Nasal/oral decongestant: Disodium cromoglycate spray -->block degranulation of mast cells and basophils |
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Regarding allergic rhinitis pharmacotherapy, antihistimines
A. block effects of released histamine by competing for H-1 receptors B. vasconstrictors. May be helpful for a few days but prolonged use --> rhinitis medicamentosa C. block degranulation of mast cells and basophils D. block late-phase reactions but also has substantial effects on early response as well. These also decrease hyper-responsiveness. E. block late-phase reactions and decrease hyper-reactiviy, but rarely indicated; "pulse" therapy for severe allergic nasal congestion sometimes useful |
A. block effects of released histamine by competing for H-1 receptors
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Regarding allergic rhinitis pharmacotherapy, alpha-aadrenergic agonists (a nasal decongestant subtype)
A. block effects of released histamine by competing for H-1 receptors B. vasconstrictors. May be helpful for a few days but prolonged use --> rhinitis medicamentosa C. block degranulation of mast cells and basophils D. block late-phase reactions but also has substantial effects on early response as well. These also decrease hyper-responsiveness. E. block late-phase reactions and decrease hyper-reactiviy, but rarely indicated; "pulse" therapy for severe allergic nasal congestion sometimes useful |
B. vasconstrictors. May be helpful for a few days but prolonged use --> rhinitis medicamentosa
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Regarding allergic rhinitis pharmacotherapy, nasal corticosteroids
A. block effects of released histamine by competing for H-1 receptors B. vasconstrictors. May be helpful for a few days but prolonged use --> rhinitis medicamentosa C. block degranulation of mast cells and basophils D. block late-phase reactions but also has substantial effects on early response as well. These also decrease hyper-responsiveness. E. block late-phase reactions and decrease hyper-reactiviy, but rarely indicated; "pulse" therapy for severe allergic nasal congestion sometimes useful |
D. block late-phase reactions but also has substantial effects on early response as well. These also decrease hyper-responsiveness.
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Regarding allergic rhinitis pharmacotherapy, disodium cromoglycate
A. block effects of released histamine by competing for H-1 receptors B. vasconstrictors. May be helpful for a few days but prolonged use --> rhinitis medicamentosa C. block degranulation of mast cells and basophils D. block late-phase reactions but also has substantial effects on early response as well. These also decrease hyper-responsiveness. E. block late-phase reactions and decrease hyper-reactiviy, but rarely indicated; "pulse" therapy for severe allergic nasal congestion sometimes useful |
C. block degranulation of mast cells and basophils
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Regarding allergic rhinitis pharmacotherapy, systemic corticosteroids
A. block effects of released histamine by competing for H-1 receptors B. vasconstrictors. May be helpful for a few days but prolonged use --> rhinitis medicamentosa C. block degranulation of mast cells and basophils D. block late-phase reactions but also has substantial effects on early response as well. These also decrease hyper-responsiveness. E. block late-phase reactions and decrease hyper-reactiviy, but rarely indicated; "pulse" therapy for severe allergic nasal congestion sometimes useful |
E. block late-phase reactions and decrease hyper-reactiviy, but rarely indicated; "pulse" therapy for severe allergic nasal congestion sometimes useful
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When is immunotherapy indicated for allergic rhinitis?
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When other therapy fails, if the allergen is pollen. Mechanism: decrease available specific IgE, increases IgG blocking antibody, increases T suppressor cells
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What is vasomotor rhinitis?
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Oversensitive or excessive blood vessels in the nasal membrane that are hypersensitive.
More common in women than men, and develops after 20 yrs of age. Experience symptoms year-round, especially spring and fall when weather shift occurs. |
