Assignment Prof Teti

8/11/2019 Assignment Prof Teti

1/5

Nur Ikram Binti Mat Hussin

1301-1210-0189

Assignment

1) Type and etiology of acute rhinitis

Rhinitis can be divided into:1. Allergic Rhinitis

Symptomatic disorder of the nose induced by an IgE-mediated inflammation after

allergen exposure of the membranes of the nose.

2. Non Allergic Rhinitis

A. Infection

i. Virus

a) myxovirus and paramyxovirus

influenza

parainfluenza

respiratory syncytial virusb) adenovirus

c) picorna virus

enterovirus

rhinovirus

d) corona virus

ii. Bacteria

a) streptococcus

B. Metabolic Disorder

a) pregnancy

b) hiperthyroidism

C. Neoplasm

D. Vasomotor

2) Pathogenesis the spread of rhinitis into otitis media due to Eustachian tube obstruction

A. Functional : in infant and young child the tubal cartilage is lack stiffness (floppy)


2/5

B. Mechanical

i. Intrinsic

abnormal intraluminal factor that compromised lumen of Eustachian tube :

inflammation due to infection/allergy

ii. Extrinsic

increased extramural pressure: tumor/ adenoid mass

3) pathogenesis of otitis media

i. Patient has an antecedent event (infection/allergy) that result in congestion of

respiratory mucosa of upper respiratory tract including nasopharynx and eustachian

tube


3/5

ii. Congestion of mucosa in eustachian tube result in obstruction of the narrowest portion

of the tube (ithmus)

iii. Negative middle-ear pressure develop and followed by aspiration/reflux of pathogens

from nasopharynx into middle ear

iv. Since Eustachian tube is obstructed, drainage and clearance of middle ear effusion, due

to infection accumulate in middle ear

v. Microbial pathogen proliferate in secretions, resulting a suppurative and symptomatic

otitis media

4) type of chronic suppurative otitis media

A. inactive

no active secretion from middle ear (perforation may dry/wet)

B. active

presence of secretion from middle ear

5) Type Of Tympanometry

type A: normal

type AD: discontinuity of the hearing bone

type AS: stiffness of the hearing bone

type B: effusion in middle ear

type C: Eustachian tube dysfunctional


4/5

6) what is ARIA

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative has been developed in

collaboration with the World Health Organization (WHO). It aims:

1. To Update Clinicians Knowledge Of Allergic Rhinitis

2. To Highlight The Impact Of Allergic Rhinitis On Asthma

3. To Provide An Evidence-Based Approach To Diagnosis

4. To Provide An Evidence-Based Approach To Treatment

5. To Provide A Stepwise Approach To The Management Of The Disease.

Allergic rhinitis is clinically defined as a symptomatic disorder of the nose induced by an IgE-mediated

inflammation after allergen exposure of the membranes of the nose.

Symptoms of allergic rhinitis include:

1. rhinorrhea2. nasal obstruction

3. nasal itching

4. sneezing

The new classification of allergic rhinitis:

1. based on duration, and is subdivided into "intermittent" or "persistent"

2. based on severity, and is subdivided into "mild" or "moderate-severe", depending on symptoms

and quality of life

Intermittent symptoms 4 weeks

Mild normal sleep normal daily activities, sport, leisure normal work and school no troublesome symptoms

Moderate-Severe (one or more items) abnormal sleep impairment of daily activities, sport, leisure problems caused at work or school troublesome symptoms


5/5

TRIGGERS OF ALLERGIC RHINITIS

1. Allergens

A. Aeroallergens

i. The allergens present in the homeare principally mites, domestic animals, insects or are

derived from plant origin.ii. Common outdoor allergens include pollens and moulds.

B. Occupational rhinitis

C. Latex allergy

2. Pollutants

A. Indoor air pollution includes domestic allergens and indoor gas pollutants, among which

tobacco smokeis the major source.

B. Urban-type pollution is primarily of automobile origin and the principal atmospheric

pollutants include ozone, oxides of nitrogenand sulphur dioxide. These may be involved in

the aggravation of nasal symptoms in patients with either allergic rhinitis, or, in non-allergic

subjects.C. Diesel exhaustmay enhance the formation of IgE and allergic inflammation.

3. Aspirin

Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) commonly induce rhinitis and

asthma.

The treatment of allergic rhinitisshould combine:

1. allergen avoidance (when possible)

2. pharmacotherapy

3.

immunotherapy

Stepwise treatment proposed:

1. Mild intermittent rhinitis: oral H1-antihistamines.

2. Moderate-Severe intermittent rhinitis: Intranasal beclomethasone (300-400g daily). If needed,

after a week of treatment, oral H1-antihistamines and/or a short term course of oral

corticosteroids will be added.

3. Mild persistent rhinitis: Treatment with oral H1-antihistamines or a low dose (100-200 g) of

intranasal beclomethasone will be sufficient.

4. Moderate-Severe persistent rhinitis: Intranasal beclomethasone (300-400 g daily). If

symptoms are severe, add oral H1-antihistamines and/or a short course of oral corticosteroids

at the beginning of the treatment.

Reference

1. Bluestone CD. Pediatric Otolaryngology vol I 3rded. 1996 pg. 411-598

2. Bousquet J. Pocket guide ARIA 2001

Assignment Prof Teti

Documents

Transcript of Assignment Prof Teti