Respiratory · UKMLA & AKT
Allergic rhinitis
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise allergic rhinitis — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Nasal obstruction - bilateral, fluctuating; worse lying down
- Watery rhinorrhoea - anterior drip or post-nasal drip
- Sneezing - paroxysmal; driven by histamine stimulation of sensory nerves
- Nasal pruritus - itch of nose, palate, throat; 'allergic salute' sign
- Allergic conjunctivitis - bilateral red, itchy, watery eyes; present in up to 70% of seasonal cases
- Examination - pale/boggy nasal mucosa, clear secretions, allergic shiners, Dennie-Morgan lines
Allergic rhinitis is always bilateral. Unilateral blockage, epistaxis, or discharge requires urgent ENT referral to exclude tumour or foreign body.
Always ask about wheeze and chest tightness in rhinitis patients - and always assess rhinitis in patients with poorly controlled asthma. The unified airway means nasal inflammation worsens asthma.
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