MCQ Quiz: Allergies and Cold Self-Care

Welcome, PharmD students, to this MCQ quiz on Self-Care for Allergies and the Common Cold! These prevalent conditions often lead patients to seek advice and effective non-prescription remedies from their pharmacists. A thorough understanding of symptom differentiation, appropriate product selection, patient counseling for both pharmacological and non-pharmacological measures, and recognizing exclusions for self-treatment is crucial. This quiz will test your knowledge on managing allergic rhinitis, common cold symptoms, and associated coughs, empowering you to provide optimal patient care. Let’s dive in!

1. Which of the following symptoms is more characteristic of allergic rhinitis than the common cold?

• a) Sore throat
• b) Frequent, paroxysmal sneezing and itchy, watery eyes
• c) Low-grade fever
• d) Productive cough

Answer: b) Frequent, paroxysmal sneezing and itchy, watery eyes

2. What is the primary mechanism of action of oral decongestants like pseudoephedrine and phenylephrine?

• a) They block histamine H1 receptors.
• b) They act as alpha-adrenergic agonists, causing vasoconstriction in the nasal mucosa.
• c) They inhibit prostaglandin synthesis.
• d) They suppress the cough reflex center.

Answer: b) They act as alpha-adrenergic agonists, causing vasoconstriction in the nasal mucosa.

3. A common cold is typically caused by:

• a) Bacteria
• b) Viruses
• c) Fungi
• d) Allergens

Answer: b) Viruses

4. Which non-prescription intranasal corticosteroid is indicated for the relief of nasal symptoms of allergic rhinitis?

• a) Oxymetazoline
• b) Fluticasone propionate
• c) Cromolyn sodium
• d) Saline nasal spray

Answer: b) Fluticasone propionate

5. Rebound congestion (rhinitis medicamentosa) is a potential adverse effect associated with prolonged use (more than 3-5 days) of which type of product?

• a) Oral antihistamines
• b) Topical (intranasal) decongestants like oxymetazoline
• c) Intranasal corticosteroids
• d) Oral expectorants

Answer: b) Topical (intranasal) decongestants like oxymetazoline

6. Which generation of oral antihistamines is more likely to cause sedation?

• a) Second-generation (e.g., loratadine, cetirizine)
• b) First-generation (e.g., diphenhydramine, chlorpheniramine)
• c) Both generations cause equal sedation.
• d) Neither generation typically causes sedation.

Answer: b) First-generation (e.g., diphenhydramine, chlorpheniramine)

7. Dextromethorphan is a non-prescription medication primarily used as a(n):

• a) Expectorant
• b) Antitussive
• c) Decongestant
• d) Antihistamine

Answer: b) Antitussive

8. Guaifenesin is an over-the-counter medication indicated for:

• a) Suppressing a dry, hacking cough.
• b) Relieving nasal congestion.
• c) Helping to loosen phlegm and thin bronchial secretions to make coughs more productive.
• d) Reducing fever and body aches.

Answer: c) Helping to loosen phlegm and thin bronchial secretions to make coughs more productive.

9. Which of the following is an exclusion for self-treatment of the common cold?

• a) Sore throat lasting 1-2 days.
• b) Fever >101.5°F (38.6°C).
• c) Clear nasal discharge.
• d) Symptoms lasting less than 3 days.

Answer: b) Fever >101.5°F (38.6°C).

10. Non-pharmacological recommendations for managing symptoms of the common cold include:

• a) Avoiding fluids to reduce nasal secretions.
• b) Strenuous exercise to sweat out the virus.
• c) Adequate rest, increased fluid intake, and use of a humidifier.
• d) Consuming large amounts of dairy products.

Answer: c) Adequate rest, increased fluid intake, and use of a humidifier.

11. What is the recommended onset of action for intranasal corticosteroids when used for allergic rhinitis?

• a) Within minutes
• b) Several hours to days, with full effect taking up to 1-2 weeks
• c) Immediately upon first spray
• d) Only after one month of continuous use

Answer: b) Several hours to days, with full effect taking up to 1-2 weeks

12. A patient with allergic rhinitis who needs a non-sedating oral antihistamine could be recommended:

• a) Diphenhydramine
• b) Chlorpheniramine
• c) Fexofenadine
• d) Doxylamine

Answer: c) Fexofenadine

13. Which of the following is a key counseling point for patients using intranasal cromolyn sodium for allergic rhinitis?

• a) It provides immediate relief of symptoms.
• b) It is most effective when started before allergen exposure and used regularly throughout the allergy season.
• c) It commonly causes significant drowsiness.
• d) It should only be used for a maximum of 3 days.

Answer: b) It is most effective when started before allergen exposure and used regularly throughout the allergy season.

14. A common symptom of a cold that typically appears first is:

• a) Productive cough
• b) High fever
• c) Sore throat
• d) Chest pain

Answer: c) Sore throat

15. Exclusions for self-treatment of allergic rhinitis include:

• a) Symptoms of itchy nose and sneezing.
• b) Symptoms unresponsive to 2-4 weeks of non-prescription treatment.
• c) Seasonal allergies diagnosed by a physician in the past.
• d) Requirement for allergen avoidance.

Answer: b) Symptoms unresponsive to 2-4 weeks of non-prescription treatment.

16. Which dietary supplement has been studied for its potential to reduce the duration of the common cold, although evidence is mixed and it can cause nausea?

• a) Vitamin D
• b) Zinc (lozenges or syrup)
• c) Melatonin
• d) Glucosamine

Answer: b) Zinc (lozenges or syrup)

17. What is a common non-pharmacological approach to managing allergic rhinitis?

• a) Increasing exposure to known allergens to build immunity.
• b) Using HEPA filters and practicing allergen avoidance (e.g., dust mites, pollen).
• c) Frequently using intranasal decongestants.
• d) Ignoring symptoms until they become severe.

Answer: b) Using HEPA filters and practicing allergen avoidance (e.g., dust mites, pollen).

18. Antitussives are generally recommended for:

• a) Productive coughs to help expel mucus.
• b) Non-productive coughs that are bothersome or interfere with sleep.
• c) All types of coughs regardless of cause.
• d) Coughs associated with bacterial infections.

Answer: b) Non-productive coughs that are bothersome or interfere with sleep.

19. A patient with hypertension should be cautious when using which class of non-prescription cold medications?

• a) Saline nasal sprays
• b) Oral decongestants (e.g., pseudoephedrine, phenylephrine)
• c) Second-generation antihistamines
• d) Guaifenesin

Answer: b) Oral decongestants (e.g., pseudoephedrine, phenylephrine)

20. What is the primary benefit of using saline nasal sprays or rinses for cold or allergy symptoms?

• a) They directly kill viruses and bacteria.
• b) They help to moisturize nasal passages, relieve dryness, and clear mucus or irritants.
• c) They provide long-lasting decongestion for up to 12 hours.
• d) They suppress the cough reflex.

Answer: b) They help to moisturize nasal passages, relieve dryness, and clear mucus or irritants.

21. Echinacea is a herbal supplement sometimes used for colds. What does the current scientific evidence suggest about its efficacy?

• a) It consistently and significantly shortens the duration of colds.
• b) Evidence is conflicting and not strongly supportive of significant benefit.
• c) It is proven to prevent colds entirely.
• d) It is a potent antiviral agent.

Answer: b) Evidence is conflicting and not strongly supportive of significant benefit.

22. A “productive cough” is characterized by:

• a) A dry, hacking sound without mucus.
• b) The expulsion of mucus or phlegm from the respiratory tract.
• c) A tickling sensation in the throat.
• d) A cough that only occurs at night.

Answer: b) The expulsion of mucus or phlegm from the respiratory tract.

23. Exclusions for self-treatment of cough include:

• a) Cough lasting less than 1 week.
• b) Cough accompanied by shortness of breath or chest pain.
• c) Cough associated with a common cold.
• d) Mild, non-productive cough.

Answer: b) Cough accompanied by shortness of breath or chest pain.

24. When counseling on the use of medicated throat lozenges containing local anesthetics (e.g., benzocaine, dyclonine) for sore throat, it’s important to advise:

• a) They will cure the underlying infection.
• b) They provide temporary relief of pain and irritation.
• c) They should be chewed thoroughly for best effect.
• d) They are effective for treating strep throat.

Answer: b) They provide temporary relief of pain and irritation.

25. Combination cold products often contain multiple ingredients. What is a potential disadvantage of using such products?

• a) They are always less expensive.
• b) Patients may be exposed to unnecessary medications for symptoms they don’t have, increasing risk of side effects.
• c) They are always more effective than single-ingredient products.
• d) They typically have fewer drug interactions.

Answer: b) Patients may be exposed to unnecessary medications for symptoms they don’t have, increasing risk of side effects.

26. Intranasal corticosteroids are effective for allergic rhinitis because they primarily:

• a) Provide immediate vasoconstriction.
• b) Exert a broad anti-inflammatory effect in the nasal passages.
• c) Block histamine release only.
• d) Act as a potent systemic decongestant.

Answer: b) Exert a broad anti-inflammatory effect in the nasal passages.

27. For a patient complaining of a common cold with nasal congestion, sore throat, and mild aches, a pharmacist might reasonably recommend:

• a) An antibiotic.
• b) A combination of an oral decongestant, an analgesic, and supportive non-pharmacological care.
• c) Only an antitussive.
• d) High-dose vitamin C as a primary treatment.

Answer: b) A combination of an oral decongestant, an analgesic, and supportive non-pharmacological care.

28. Which of the following is an important counseling point for second-generation oral antihistamines like loratadine?

• a) They should be taken with a full glass of grapefruit juice.
• b) They are generally non-sedating or less sedating than first-generation agents.
• c) They are most effective when taken only after severe symptoms develop.
• d) They have a very rapid onset of action, within 5 minutes.

Answer: b) They are generally non-sedating or less sedating than first-generation agents.

29. If a patient has a common cold, how long do symptoms typically last with or without treatment?

• a) 1-2 days
• b) 7-10 days
• c) 3-4 weeks
• d) Indefinitely, unless treated with antibiotics.

Answer: b) 7-10 days

30. “Allergic shiners” (dark circles under the eyes) and a transverse nasal crease are sometimes observed in patients with:

• a) Acute bacterial sinusitis
• b) The common cold
• c) Chronic allergic rhinitis
• d) Influenza

Answer: c) Chronic allergic rhinitis

31. The anticholinergic effects of first-generation antihistamines can lead to side effects such as:

• a) Diarrhea and increased salivation.
• b) Dry mouth, urinary retention, and constipation.
• c) Bradycardia and hypotension.
• d) Increased nasal secretions.

Answer: b) Dry mouth, urinary retention, and constipation.

32. When is it most appropriate to recommend an expectorant like guaifenesin?

• a) For a dry, irritating cough.
• b) For a cough that is productive but the mucus is thick and difficult to expel.
• c) To prevent a cough from developing during a cold.
• d) For chronic cough due to asthma.

Answer: b) For a cough that is productive but the mucus is thick and difficult to expel.

33. A patient asks if they can use an expired intranasal decongestant spray. The best advice is:

• a) Yes, as long as it still sprays.
• b) Yes, but use twice the recommended dose.
• c) No, expired medications may be less effective or potentially harmful and should be discarded properly.
• d) Yes, but only for one day.

Answer: c) No, expired medications may be less effective or potentially harmful and should be discarded properly.

34. Which statement about vitamin C for common colds is most accurate based on current evidence?

• a) High doses of vitamin C are proven to prevent colds in the general population.
• b) Routine supplementation with vitamin C may slightly shorten the duration of a cold but does not prevent it in most people.
• c) Vitamin C is a potent antiviral drug that eliminates cold viruses.
• d) There is no scientific research on vitamin C and colds.

Answer: b) Routine supplementation with vitamin C may slightly shorten the duration of a cold but does not prevent it in most people.

35. A key aspect of self-care for allergies is identifying and:

• a) Consuming known allergens in small amounts.
• b) Avoiding known triggers or allergens where possible.
• c) Using only homeopathic remedies.
• d) Taking antibiotics prophylactically.

Answer: b) Avoiding known triggers or allergens where possible.

36. Diphenhydramine is available in topical formulations for itching, but its use should be cautioned due to:

• a) Risk of systemic absorption and sedation, especially if applied to large areas or broken skin.
• b) Its ineffectiveness as an antipruritic.
• c) Its potent vasoconstrictive properties.
• d) The fact it only works for bacterial skin infections.

Answer: a) Risk of systemic absorption and sedation, especially if applied to large areas or broken skin.

37. If a patient with a cold develops symptoms like facial pain/pressure, purulent nasal discharge for several days, and a worsening of symptoms after initial improvement, they should be referred to a physician to rule out:

• a) Allergic rhinitis
• b) Viral pharyngitis
• c) Acute bacterial sinusitis
• d) Simple uncomplicated cold

Answer: c) Acute bacterial sinusitis

38. Nasal wetting agents or emollients (e.g., saline, propylene glycol sprays) are useful for:

• a) Treating severe nasal polyps.
• b) Relieving nasal dryness and irritation, often caused by dry air or other medications.
• c) Providing potent, long-lasting decongestion.
• d) Curing allergic rhinitis.

Answer: b) Relieving nasal dryness and irritation, often caused by dry air or other medications.

39. Which is a self-care exclusion for sore throat?

• a) Mild scratchiness.
• b) Sore throat accompanied by difficulty swallowing or breathing.
• c) Sore throat present for only 12 hours.
• d) Sore throat after yelling at a sports event.

Answer: b) Sore throat accompanied by difficulty swallowing or breathing.

40. The goal of using non-prescription analgesics/antipyretics (e.g., acetaminophen, ibuprofen) during a cold is to:

• a) Cure the viral infection.
• b) Relieve symptoms such as fever, headache, and muscle aches.
• c) Prevent the development of a cough.
• d) Act as a primary decongestant.

Answer: b) Relieve symptoms such as fever, headache, and muscle aches.

41. When recommending products for children with cold and cough symptoms, pharmacists must be particularly cautious due to:

• a) Children’s immunity making them resistant to all medications.
• b) Increased risk of side effects, lack of efficacy data for some agents in young children, and potential for dosing errors.
• c) The fact that children never experience cold symptoms.
• d) FDA requirements that all children receive multiple medications for colds.

Answer: b) Increased risk of side effects, lack of efficacy data for some agents in young children, and potential for dosing errors.

42. A patient reports their allergic rhinitis symptoms are worst in the spring and fall when pollen counts are high. This is characteristic of:

• a) Perennial allergic rhinitis
• b) Seasonal allergic rhinitis
• c) Nonallergic rhinitis
• d) Vasomotor rhinitis

Answer: b) Seasonal allergic rhinitis

43. What is the primary advantage of second-generation antihistamines over first-generation antihistamines for allergic rhinitis?

• a) They are more effective at relieving nasal congestion.
• b) They have a significantly lower incidence of sedation and anticholinergic side effects.
• c) They only need to be taken once a month.
• d) They are available in more dosage forms.

Answer: b) They have a significantly lower incidence of sedation and anticholinergic side effects.

44. Camphor and menthol are common ingredients in topical rubs and steam inhalants. They primarily provide symptomatic relief by:

• a) Acting as potent antiviral agents.
• b) Producing a local anesthetic or cooling/warming sensation that can make airways feel less congested.
• c) Systemically reducing inflammation.
• d) Curing the underlying cause of cough or congestion.

Answer: b) Producing a local anesthetic or cooling/warming sensation that can make airways feel less congested.

45. A critical step in assessing whether a patient is a candidate for self-care for cold or allergy symptoms is:

• a) Recommending the newest product available.
• b) Asking about current symptoms, medical conditions, current medications, and allergies (SCHOLAR-MAC or QuEST).
• c) Assuming all patients can self-treat.
• d) Only asking about the patient’s preferred brand.

Answer: b) Asking about current symptoms, medical conditions, current medications, and allergies (SCHOLAR-MAC or QuEST).

46. If a patient is using an intranasal corticosteroid for allergic rhinitis, they should be counseled that:

• a) It can be shared with other family members.
• b) They should aim the spray towards the center of their nose (septum).
• c) Consistent daily use is important for optimal effect, and it may take days to weeks for full relief.
• d) It will also treat their asthma.

Answer: c) Consistent daily use is important for optimal effect, and it may take days to weeks for full relief.

47. Which symptom, if present with a cough, warrants immediate medical attention?

• a) Mild throat irritation
• b) Coughing up blood (hemoptysis)
• c) A cough that is occasionally productive of clear mucus
• d) A cough that has lasted for 2 days

Answer: b) Coughing up blood (hemoptysis)

48. What is the role of zinc in relation to the common cold, according to some studies?

• a) It prevents the cold virus from entering nasal cells.
• b) It may inhibit viral replication and reduce inflammation if taken early in the course of a cold.
• c) It boosts the immune system to fight any type of infection.
• d) It primarily acts as an antitussive.

Answer: b) It may inhibit viral replication and reduce inflammation if taken early in the course of a cold.

49. A common counseling point for oral decongestants is the potential for side effects such as:

• a) Sedation and dizziness.
• b) Increased heart rate, palpitations, and insomnia.
• c) Diarrhea and abdominal cramping.
• d) Dry mouth and blurred vision (more typical of anticholinergics).

Answer: b) Increased heart rate, palpitations, and insomnia.

50. When a patient asks for “something strong” for their cold, the pharmacist should first:

• a) Recommend the product with the highest dose of active ingredients.
• b) Assess the patient’s specific symptoms to determine the most appropriate targeted therapy.
• c) Tell them that non-prescription products are not strong.
• d) Immediately refer them to a physician.

Answer: b) Assess the patient’s specific symptoms to determine the most appropriate targeted therapy.