Perform otoscopy to look for tympanic membrane retraction, air/fluid levels, or bubbles. Pneumatic otoscopy can be considered to look for abnormal tympanic membrane mobility. These findings can be associated with allergic rhinitis, particularly if eustachian tube dysfunction or secondary otitis media is present.
A patient has intermittent allergic rhinitis if symptoms occur less than 4 days a week or 4 weeks of the year. Persistent allergic rhinitis is diagnosed if symptoms occur more than 4 days per week and more than 4 weeks of the year. Nasal airway resistance is increased in those with allergic rhinitis, and it is intensified in the supine position compared with the upright position.
Because allergic rhinitis has a significant genetic component, a positive family history for atopy makes the diagnosis more likely. In fact, the risk for allergic rhinitis is greater if both parents are atopic than if one parent is atopic. However, the cause of allergic rhinitis appears to be multifactorial, and a person with no family history of allergic rhinitis can develop allergic rhinitis.
For more on allergic rhinitis, read here.
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Cite this: Michael A. Kaliner. Fast Five Quiz: Test Your Knowledge About Fall Allergies - Medscape - Jul 06, 2020.