Cita Laelika

Catur Ramadanti

RHINITIS ALERGIC Hanifah Okviandita

Rania Samosir
Rini Novita sari
Wecitria Bimaviola
CASE
A 35-year-old Female with a history of asthma presents to your office with
symptoms of nasal itching , sneezing , and rhinorrhea. She states she feels this
way most days but her symptoms are worse in the spring and fall . She has had
difficulty sleeping because she is always congested. She states she has taken
diphenhydramine (Benadryl) with no relief . She does not smoke cigarettes and
does not have exposure to passive smoke but she does have 2 cats at home . On
examination , she appears tired but is in no respiratory distress. Her vital signs
are :
temperature : 98,8°f (37°C)
blood pressure : 128/84 mmHg
Hg : 88 beats/min
Respiratory rate : 18 breath/ min

The Mucosa of her nasal turbinates appear swollen (boggy) and have a
pale,bluish-gray color. Thin and watery secretions are seen. No abnormalities are
seen on ear examination. There is no cervical lymphadenopathy noted and her
lungs are clear.
 KEYWORD

- A 35 year old female - she does have 2 cats

-Nasal itching -The nasal turbinats appear swollen
(boggy)
-Sneezing
- have a pale
-Rhinorrhea
- Bluish-gray color
-The symptoms are worse in the spring
and fall - thin and watery secretion
-She can’t sleep because of congested
-She has taken diphenhydramine
(Benadryl) with no relief
HYPOTHESIS

Allergic Rhinitis
DEFINITION
Allergic rhinitis is an inflammation of the nasal
membranes that is characterized by sneezing, nasal
congestion , nasal itching, and rhinorrhea.
ETIOLOGY
The cause of alergic rhinitis is divided into 4 :
Inhalasi ( through the air breathing )
Such as = house dust,mold,mites,animal fur
Ingestan ( through food )
Such as = milk,eggs,peanut,shrimp,fish,and others
Injection ( through injection or punctures )
Such as = penicillin,bee stings
Contacan ( through skin or mucosal contact )
Such as = cosmetic ingredient,jewelry
THE SYMPTOMS
- Sneeze
- Rhinorrhea
- itching of the nose, eyes , throat , skin,
or any area
- cough
- nasal congestion
- watery eyes
- dark circles under the eyes
- headache constantly
RISK FACTOR
1. External factor 2. Internal Factor
 - Allergen  - Genetic
 - Pets
 - Environtmental Air pollution
 - Cigarette smoke
 - Kitchen smoke
PATHOPHYSIOLOGY
Allergens Mites , dust , flower
fragments

Macrofag

Sel T

Sel B

Ig E active and binds to allergens

Allergen attached to mast cells

granulation of mast cells and basophils Re-exposure occurs

the release of mediators

 the release of mediators

bronchocontriction Stimulates nerve

cells
Goblet cells have
hypersecretion
Out of breath
Arise itching around
the nose and eyes
There is a buildup
of secretion
dyspnea
Arise discomfort
Occurs rhinorrhea
and nasal
anxious congestion

The breath pattern

is not effective
PREVENTION
regularly clean cushions, curtains and upholstered furniture, either by washing or
vacuuming them
don't allow pets in bedrooms
wash pets at least once a fortnight
wear wraparound sunglasses to protect your eyes from pollen
keep doors and windows shut during mid-morning and early evening, when there's
most pollen in the air
shower, wash your hair and change your clothes after being outside
avoid grassy areas, such as parks and fields, when possible
TREATMENT
A. avoidance of allergen
B. treatment with drugs
antihistaminics,corticosteroid topical.
THANK YOU