module 3 peds recurrent epistaxis, nasal foreign body

Question 1

medication etiologies for epistaxis

Answer 1

medication
- NSAIDs
- anticoagulants
- chronic topical nasal sprays w/ corticosteroids
- antihistamine decongestants
- cocaine

Question 2

local etiologies for epistaxis

Answer 2

• nasal trauma
• allergies
• septal abnormalities
• neoplasia
• juvenile nasopharyngeal angiofibroma
• inflammation

Question 3

systemic etiologies for epistaxis

Answer 3

• coagulopathies
• allergies
• polyps
• hemangiomas
• FB
• viral or bacterial infections

Question 4

environmental etiologies for epistaxis

Answer 4

• dry climates
• dryness from heaters in winter

Question 5

little’s area

Answer 5

anterior portion of the nasal septum
- kiesselbach plexus vessels meet under the thin nasal mucosa

Question 6

Hallmark sign for coagulopathy

Answer 6

mucocutaneous bleeding beyond epistaxis
- easy bruisability
- menorrhagia
- GI bleeding
Von Willebrand disease
Platelet aggregation disorders

Question 7

recurrent epistaxis physical exam

Answer 7

Nares
- fresh or old clots
- nasal masses
- FB
- polyps
- raw, red Little’s area
Nasal mucosa
- medial surface dry, cracked, excoriated, or scabbed
Signs of nasal allergy
- allergic shiners,
Dennie-Morgan lines
- adenoidal facies
- pale boddy mucosa

Question 8

nasal foreign body s/s

Answer 8

recurrent unilateral purulent nasal discharge
foul odor
epistaxis
nasal obstruction
mouth breathing

Question 9

nasal FB physical exam

Answer 9

unilateral, purulent, foul smelling nasal discharge