Nose and paranasal sinuses: non-allergic rhinitis with eosinophilia: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Nose and paranasal sinuses: non-allergic rhinitis with eosinophilia

Sample item

A 40-year-old has perennial sneezing and profuse watery rhinorrhoea. Skin prick tests are negative and serum total IgE is normal, but nasal smear shows many eosinophils. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Non-allergic rhinitis with eosinophilia syndrome

Non-allergic rhinitis with eosinophilia syndrome (NARES) mimics allergic rhinitis, with many nasal eosinophils but negative allergy tests. It responds well to intranasal corticosteroids and may precede aspirin sensitivity and polyposis. Vasomotor rhinitis lacks eosinophils.

Option by option

  • A. Vasomotor rhinitis

    Vasomotor rhinitis has a smear without eosinophils.

  • B. Allergic rhinitis

    Allergic rhinitis requires a positive skin test or specific IgE.

  • C. Non-allergic rhinitis with eosinophilia syndrome (correct)

    Correct. Nasal eosinophilia with negative allergy testing defines this condition.

  • D. Infective rhinitis

    Infective rhinitis shows neutrophils and a short illness.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Non-allergic rhinitis with eosinophilia syndrome. Non-allergic rhinitis with eosinophilia syndrome (NARES) mimics allergic rhinitis, with many nasal eosinophils but negative allergy tests.

Why is "Vasomotor rhinitis" not the answer?

Vasomotor rhinitis has a smear without eosinophils.

Why is "Allergic rhinitis" not the answer?

Allergic rhinitis requires a positive skin test or specific IgE.

Why is "Infective rhinitis" not the answer?

Infective rhinitis shows neutrophils and a short illness.

What concept does this question test?

It tests Nose and paranasal sinuses: non-allergic rhinitis with eosinophilia in ENT. It responds well to intranasal corticosteroids and may precede aspirin sensitivity and polyposis. Vasomotor rhinitis lacks eosinophils.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nose and paranasal sinuses: non-allergic rhinitis with eosinophilia?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.