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  #1  
Old 03-05-2012
tyagee's Avatar
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Question How to confirm the diagnosis of Allergic Rhinitis?

An 8-year-old patient presents to her pediatrician complaining of profuse, watery rhinorrhea, difficulty breathing, and itching of the nose and palate. There is a family history of atopy. During the physical examination, the child has paroxysmal sneezing. The physician suspects that the patient has allergic rhinitis. To substantiate the diagnosis, the physician should perform which of the following tests?
(A) A radioallergosorbent test (RAST)
(B) A Coombs’ test
(C) A nasal smear for eosinophils
(D) A scratch test
(E) Immunoglobulin E (IgE) levels
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  #2  
Old 03-05-2012
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Scratch testing is considered the primary method for identifying specific allergic triggers of rhinitis.

Scratch tests are generally considered to be more sensitive and cost effective than RAST and have the further advantage of providing physicians and patients with immediate results.
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Old 03-05-2012
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NO , a nasal SMEAR for eosinophils is the COrrect ans...
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Old 03-05-2012
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@
dr.dhruvdesai

reason?
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Old 03-05-2012
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I'd go with dr.dhruvdesai on this one - skin testing is the gold standard for specificity (and less expensive than RAST), as drotho mentioned. However, nasal smear for eosinophils is a better screening test, quick and easy with good positive predictive value (according to Harriet Lane Handbook).
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Old 03-05-2012
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MY reason is that if this question had an option sayin ....

"history and physical exam"

that would be correct...and then UW too says Eosinophils in smear is confirmatory test...

so in exam be careful...

for diagnosis..."hist and exam" is enof..., but if the nature of the question be and requires...to confirm ...then Eosinophils is correct...

even UW says so

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Old 03-05-2012
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i will go for C just like Dr. dru said with the same explanation he gave.
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Old 03-05-2012
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thats correct.
ans is nasal smear for eosinophils.
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Allergies-, Internal-Medicine-, Otolaryngology-, Step-2-Questions

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