August 24, 2012

Patient with allergic rhinitis and acute urticaria

A patient with allergic rhinitis develops acute urticaria. This is best relieved by:

a) Antigen avoidance
b) Immunotherapy against the known offending antigen
c) Antihistamine-decongestant preparation
d) Topical adrenergic agonist
e) Oral adrenergic agonist
f) Systemic corticosteroids
g) Topical corticosteroids
h) Subcutaneous injections of atropine
i) Conjunctival challenge
j) Combination of H1 and H2 antagonists

The correct answer is J

For the treatment of acute urticaria, the combination of H1 and H2 antagonists is more effective than the H1 antagonist alone; but for the treatment of pruritus from acute allergic reactions, the H1 antagonist is more effective than the H2 antagonist, and the combination offers no additional benefit.

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