10-04-2010, 03:49 PM
A 22-year-old man comes to the office for management of his allergic rhinitis. He has been told by various physicians over the years that he suffers from this disorder, but that he has never had any medications prescribed. Rather, he has been instructed to avoid certain environmental exposures. He reports that each spring and early summer he routinely suffers from sneezing, nasal discharge, and pruritus as well as eye itching and watering. The symptoms often abate in the fall and winter, although he occasionally has symptoms during this time. A survey of his environmental exposures reveals no toxic irritants in the workplace, perfumes, or colognes that seem to trigger the symptoms. However, cat hair exacerbates his symptoms. He works approximately an hour from his home and that he commutes by car. The most appropriate next step in management is to
A. advise him to have his home cleaned weekly to decrease the number of triggers
B. initiate over-the counter antihistamine therapy
C. prescribe an intranasal antihistamine
D. prescribe an intranasal steroid
E. prescribe an oral antihistamine
A. advise him to have his home cleaned weekly to decrease the number of triggers
B. initiate over-the counter antihistamine therapy
C. prescribe an intranasal antihistamine
D. prescribe an intranasal steroid
E. prescribe an oral antihistamine