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Allergic rhinitis — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareAllergic rhinitisUSMLE Step 3

A 29-year-old teacher has 2 months of sneezing, nasal congestion, and itchy eyes that worsen when she cleans her apartment. She has pale boggy nasal mucosa and clear rhinorrhea. Lungs are clear. She has tried an oral antihistamine intermittently with partial relief. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Start daily intranasal corticosteroid therapy

Persistent allergic rhinitis responds best to regular intranasal corticosteroids; antibiotics and imaging are unnecessary without bacterial sinusitis features.

Reference: Allergic rhinitis practice parameters: https://www.aaaai.org/