Case Academy test

1.Treatment Adjustment

While awaiting diagnostic testing, what would be your next step in managing Mary’s symptoms? *

A. Switch to a second-generation antihistamine (e.g., cetirizine, loratadine) for better symptom control with less sedation.

B. Introduce a nasal corticosteroid (e.g., fluticasone or mometasone) to address congestion and overall symptom burden.

C. Recommend a combination therapy (e.g., azelastine/fluticasone nasal spray) to target multiple symptom pathways.

D. Continue diphenhydramine but adjust dosing frequency or timing to reduce drowsiness.

2. Treatment Recommendation

Would you recommend further diagnostic testing to better understand Mary’s triggers? *

A. Yes, order serum-specific IgE testing for aeroallergens to identify potential allergens for tailored treatment.

B. Yes, refer for skin prick testing to confirm sensitivities to aeroallergens.

C. No, rely on Mary’s symptom history to guide treatment without additional testing.

D. No, diagnostic testing is unnecessary for seasonal allergic rhinitis with known triggers.

3. Patient Education and Counseling

How would you address Mary’s frustration with her current treatment? (Select the best approach.) *

A. Educate Mary about the limitations and side effects of first-generation antihistamines and explain the benefits of newer treatment options.

B. Suggest lifestyle modifications, such as allergen avoidance strategies, while maintaining her current treatment.

C. Encourage her to trial a new therapy with clear instructions on proper use and monitoring for effectiveness.

D. Validate her concerns but recommend staying on the current therapy to avoid changes.

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