American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended treatment for viral sinusitis?

1. Amoxicillin

2. Intranasal glucocorticoids, antihistamines, and topical decongestants

3. Oral decongestants and antibiotics

4. Cough suppressants and NSAIDs

The correct answer is: Intranasal glucocorticoids, antihistamines, and topical decongestants

The recommended treatment for viral sinusitis includes the use of intranasal glucocorticoids, antihistamines, and topical decongestants. This approach is appropriate because viral sinusitis typically resolves without the need for antibiotics, which are effective only for bacterial infections. Intranasal glucocorticoids can help to reduce inflammation and edema in the nasal passages, leading to easier drainage and alleviating symptoms such as nasal congestion. Antihistamines may help manage any associated allergic symptoms or nasal discharge. Topical decongestants are effective in providing short-term relief from nasal congestion, thus improving overall comfort. Using antibiotics or oral decongestants is not recommended since these do not address the viral nature of the infection and may lead to unnecessary side effects or complications. Cough suppressants and NSAIDs can provide symptomatic relief but do not specifically target the underlying issue of viral sinusitis. Therefore, the combination of intranasal glucocorticoids, antihistamines, and topical decongestants forms the most effective and evidence-based treatment strategy.