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Patient case: Allergic Rhinitis Dust Mite Allergy

Discussion

A 25-year-old male presents with a 3-year history of intermittent sneezing, itchy nose, and watery eyes, primarily during the spring and fall seasons. He reports that these symptoms worsen when he is in dusty environments, particularly in his bedroom, where he spends most of his time. He mentions that his symptoms improve when he is away from home, such as when traveling or during vacations. On examination, the patient has clear nasal discharge, congestion, and pale, swollen nasal turbinates. Skin prick testing reveals a significant sensitivity to dust mites. Based on his clinical presentation and allergy test results, the diagnosis of allergic rhinitis due to dust mite allergy is confirmed. He is advised to use antihistamines for symptom relief and nasal corticosteroids for better long-term control. The patient is also advised to reduce exposure to dust mites by using allergen-proof bed covers and regularly washing bedding in hot water

Questions
1. What is the most likely diagnosis for this patient based on the symptoms and allergy testing?

A) Acute sinusitis

B) Allergic rhinitis due to dust mite allergy

C) Nasal polyps

D) Chronic rhinosinusitis

2. Which of the following is the most common trigger for the patient's allergic rhinitis?

A) Pollen

B) Dust mites

C) Animal dander

D) Mold

3. What is the recommended first-line treatment for this patient’s symptoms?

A) Oral antibiotics

B) Intranasal corticosteroids

C) Decongestants

D) Oral antihistamines

4. What lifestyle modification is most likely to benefit this patient in managing their symptoms?

A) Use of an air purifier in the home

B) Avoidance of outdoor activities during the morning

C) Smoking cessation

D) Increase in exercise frequency

Reveal answers

Answers

1. B) Allergic rhinitis due to dust mite allergy

2. B) Dust mites

3. B) Intranasal corticosteroids

4. A) Use of an air purifier in the home