Allergic rhinitis Quiz: Ace Your Exams
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A 36-year-old man presents to the urgent care clinic for evaluation of nasal symptoms. He has had nasal itching, sneezing and congestion most days of the week for the last six weeks. He awakens with a sore throat each morning and occasionally has mild facial pressure over the maxillary sinuses. He has not had a fever, chills, or sweats. He develops similar symptoms every spring and fall and reports needing antibiotics twice per year. Symptoms are not affecting his quality of life or sleep. He has no significant past medical history. Temperature is 37.0°C (98.6°F), pulse is 70/min, respiratory rate is 16/min, and blood pressure is 122/72 mmHg. On examination, the nasal turbinates appear edematous with a bluish hue bilaterally. And clear rhinorrhea is present. There is no tenderness over the maxillary sinuses. Cobble stoning is present in the posterior pharynx without tonsillar hypertrophy, erythema, or exudate. Tympanic membranes are intact without effusion or redness. Which of the following is the best initial treatment option?
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