The Anatomy of a Question
Question
A 4-year-old girl with allergic rhinitis has been compliant with daily oral antihistamine use for the past six weeks but continues to have daily complaints of nasal itching and discharge. She also has complaints of itchy eyes with redness and tearing at least once weekly. Which of the following interventions would be the most appropriate next step in her symptom management?
Answer choice options
- A. Immunotherapy
- B. Intranasal fluticasone
- C. Intranasal oxymetazoline
- D. Oral montelukast
The incorrect options (distractors) are not totally wrong. These options can be diagramed as follows:
-
B.Intranasal fluticasone Most effective therapy for allergic rhinitis.
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C.Intranasal oxymetazoline May be considered for short-term symptom management but cause rebound nasal congestion with prolonged or frequent use.
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D.Oral montelukast Has limited effects on rhinitis symptoms like rhinorrhea.
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A.Immunotherapy Reserved for patients who have failed to achieve adequate symptom control with pharmacotherapy.
The Anatomy of an Explanation
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