Lesson 1Comprehensive history-taking for rhinitis (timing, triggers, impact on sleep/school, medication history, comorbidities)This lesson outlines a structured approach to taking a patient's history for rhinitis, focusing on onset, timing, triggers, symptom patterns, effects on sleep, school or work, past and current medications, treatment responses, associated allergies, and family and environmental factors relevant to Australian lifestyles.
Characterising nasal and ocular symptom patternsSeasonality, duration, and daily variabilityIdentifying environmental and occupational triggersAssessing sleep, school, and work impairmentMedication use, response, and adverse effectsComorbid asthma, eczema, and family historyLesson 2First-line and add-on treatments (intranasal corticosteroids, oral/IN antihistamines, intranasal antihistamine, saline irrigation)This lesson discusses pharmacologic management options, highlighting intranasal corticosteroids as the primary treatment, suitable use of oral and intranasal antihistamines, leukotriene modifiers, saline irrigation, and progressive add-on approaches based on symptom control in primary care settings.
Intranasal corticosteroids: choice and dosingOral versus intranasal antihistamine useRole of leukotriene receptor antagonistsSaline irrigation techniques and benefitsDecongestants and anticholinergic spraysStepwise escalation and de-escalation plansLesson 3Immunopathology of allergic rhinitis (IgE-mediated mechanisms, seasonal vs perennial triggers)This lesson examines IgE-mediated processes in allergic rhinitis, comparing early and late phase responses, and describes how seasonal and year-round airborne allergens cause symptoms, sensitisation patterns, and ongoing inflammation in the nasal passages.
IgE sensitisation and mast cell activation cascadeEarly and late phase inflammatory responsesRole of eosinophils, Th2 cells, and cytokinesSeasonal aeroallergens and pollination patternsPerennial indoor allergens and chronic exposureLink between immunopathology and symptom profilesLesson 4Differential diagnoses and red flags (non-allergic rhinitis, chronic sinusitis, adenoidal hypertrophy, structural obstruction, sinister causes)This lesson reviews alternative diagnoses for rhinitis symptoms, such as non-allergic rhinitis, chronic rhinosinusitis, enlarged adenoids, structural blockages, medication-induced causes, and warning signs that require prompt imaging or referral to specialists.
Non-allergic and vasomotor rhinitis patternsChronic rhinosinusitis and nasal polyposisAdenoidal hypertrophy and mouth breathingSeptal deviation and other structural causesMedication and hormonal rhinitis syndromesRed flag signs suggesting serious diseaseLesson 5Immunotherapy principles and referral indications (sublingual vs subcutaneous, patient selection, safety)This lesson covers the principles, mechanisms, and evidence for allergen immunotherapy, comparing subcutaneous and sublingual methods, indications and contraindications, patient suitability, safety measures, and criteria for referring to allergy specialists in Australia.
Immunologic basis and disease modificationEfficacy evidence and expected time courseSCIT versus SLIT: pros, cons, and logisticsEligibility criteria and key contraindicationsSafety protocols and anaphylaxis preparednessWhen and how to refer for immunotherapyLesson 6Allergy testing strategy for rhinitis (indications for skin prick testing, specific IgE, nasal cytology, when to treat empirically)This lesson explores strategies for allergy testing, including when to use skin prick tests and blood specific IgE, common interpretation issues, nasal cytology, and situations where starting treatment without tests is appropriate in clinical practice.
When to order skin prick testingSerum specific IgE: uses and limitationsSelecting relevant aeroallergen panelsBasics of nasal cytology and smear findingsInterpreting discordant test and symptom dataWhen to treat empirically without testingLesson 7Patient education and long-term follow-up (medication safety concerns, adherence coaching, scheduling reviews)This lesson focuses on educating patients and caregivers about expectations, medication safety, proper device use, adherence tips, action plans, and planning regular follow-ups to track symptom control and modify treatments as needed.
Explaining chronicity and treatment goalsCounselling on intranasal steroid safetyDemonstrating correct nasal spray techniqueImproving adherence and addressing concernsWritten self-management and action plansFollow-up intervals and monitoring controlLesson 8Environmental control and avoidance measures (pollen avoidance strategies, home filtration, timing outdoors, pet exposure guidance)This lesson provides practical advice on environmental management, such as avoiding pollen, reducing indoor allergens, using filters and ventilation, planning outdoor time, and offering guidance for homes with pets and multiple triggers common in Australia.
Pollen forecasts and timing outdoor activitiesBedroom and bedding allergen reduction stepsHEPA filtration and ventilation best practicesDust mite, mould, and cockroach control plansPet dander mitigation and rehoming counsellingBalancing avoidance with quality of lifeLesson 9Targeted ENT and general physical exam findings (nasal mucosa, polyps, conjunctival signs, throat, ear, facial features)This lesson describes a focused ear, nose, and throat examination for rhinitis, including checking nasal lining, turbinates, and septum, spotting polyps, eye and throat signs, ear issues, facial features, and noting severity indicators.
Nasal mucosa colour, oedema, and secretionsTurbinates, septum, and nasal patency testsRecognition of nasal polyps and massesOcular and conjunctival allergy signsOropharyngeal, ear, and Eustachian findingsAllergic facies and growth or dental changes
