Lesson 1Comprehensive history-taking for rhinitis (timing, triggers, impact on sleep/school, medication history, comorbidities)Dis section go outline structured history-taking for rhinitis, stressing onset, timing, triggers, symptom pattern, sleep and school or work impact, prior and current medications, response to therapy, comorbid atopy, and family and environmental context, using simple Sierra Leonean examples.
Characterizing 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)Dis section go cover pharmacologic management, stressing intranasal corticosteroids as first-line, proper use of oral and intranasal antihistamines, leukotriene modifiers, saline irrigation, and stepwise add-on strategies based on symptom control, wid advice for local availability.
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)Dis section go review IgE-mediated pathways in allergic rhinitis, contrasting early and late phase responses, and explain how seasonal and perennial aeroallergens drive symptoms, sensitization patterns, and chronic mucosal inflammation, relating to common Sierra Leonean triggers.
IgE sensitization 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)Dis section go review differential diagnoses of rhinitis, including non-allergic rhinitis, chronic rhinosinusitis, adenoidal hypertrophy, structural obstruction, medication causes, and red flag features dat warrant urgent imaging or specialist referral, wid focus on local health challenges.
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)Dis section go explain allergen immunotherapy principles, mechanisms, and evidence, compare subcutaneous and sublingual routes, outline indications and contraindications, patient selection, safety monitoring, and when to refer to allergy specialists, considering Sierra Leonean resources.
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)Dis section go discuss allergy testing strategies, including indications for skin prick testing and serum specific IgE, interpretation pitfalls, nasal cytology, and when empirical treatment without testing is reasonable or preferred in clinical practice, adapted for local labs.
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)Dis section go address patient and caregiver education, covering realistic expectations, medication safety, device technique, adherence strategies, written action plans, and scheduling structured follow-up to monitor control and adjust therapy, using community-based approaches.
Explaining chronicity and treatment goalsCounseling 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)Dis section go focus on practical environmental control, including pollen avoidance, indoor allergen reduction, filtration and ventilation strategies, timing of outdoor activities, and tailored guidance for households wid pets and mixed triggers, suited to Sierra Leonean homes.
Pollen forecasts and timing outdoor activitiesBedroom and bedding allergen reduction stepsHEPA filtration and ventilation best practicesDust mite, mold, and cockroach control plansPet dander mitigation and rehoming counselingBalancing avoidance with quality of lifeLesson 9Targeted ENT and general physical exam findings (nasal mucosa, polyps, conjunctival signs, throat, ear, facial features)Dis section go detail focused ENT and general examination in rhinitis, including inspection of nasal mucosa, turbinates, and septum, detection of polyps, conjunctival and throat findings, ear and facial features, and documentation of severity markers, wid practical tips.
Nasal mucosa color, edema, 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
