Epistaxis

Question 0

6 complaints of the nose

Answer 0

blocked
runs
reaction to irritation
\+/- smell
pressure/pain
bleed

Question 1

5 functions of nose

Answer 1

smell
filtration
humidification
airway
warming

Question 2

which important artery in posterior nose?

Answer 2

sphenopalantine

Question 3

describe typical anterior nose bleed?

Answer 3

not much blood, unilateral

Question 4

where does sphenopalantine come from?

Answer 4

Maxillary»external carotid

Question 5

describe a posterior nose bleed presentation?

Answer 5

bilateral, felt something run down back of throat, then exploded with blood out nostrils

Question 6

who is more susceptible to posterior bleeds? why?

Answer 6

elderly due to comorbidities, warfarin? HTN, athersclerosis

Question 7

2 local causes of epistaxis?

Answer 7

trauma: Macro/Micro
vessels: more flow, abnormal vessels

Question 8

3 kinds of systemic causes epistaxis?

Answer 8

atherosclerosis
coagulopathies
hypertension

Question 9

3 steps for examination

Answer 9

General: well or unwell
Vital Signs
System specific: scoping

Question 10

first thing to think of in an unstable epistaxis patient?

Answer 10

airways! Is there a clot in the back of their throat

Question 11

you can lose up to how much of your blood and be relatively normal?

Answer 11

15-20%

Question 12

behavioural treatments of epistaxis?

Answer 12

avoid tiggers, diet, humidifier

Question 13

what is something changes in resus setting during circulation?

Answer 13

go back to Airways and reassess

Question 14

where to put pressure in epistaxis?

Answer 14

soft part of nose

Question 15

GTN patch in epistaxis?

Answer 15

take it off

Question 16

3 vasoconstrictors:

Answer 16

Adrenaline
cocaine
phenylephrine oxymetazoline

Question 17

adrenaline vasoconstricts how?

Answer 17

a&B nonselective adrenergic agonist

Question 18

how does cocaine cause vasoconstriction?

Answer 18

Na+ channel blocker, NorAdrenaline reuptake inhibitor

Question 19

how does phenylephrine oxymetazoline vasoconstrict?

Answer 19

a-adrenergic agonist

Question 20

platelets and clotting factors, which is worse to not have

Answer 20

platelets

Question 21

von willebrand disease 3 types

Answer 21

1: not enough
2: enough but malformed
3: None

Question 22

coag or platelet defects cause profuse bleeding from cuts?

Answer 22

platelet

Question 23

coag or platelet defects cause prolonged epistaxis?

Answer 23

platelets

Question 24

haematuria in coag or platelet defects?

Answer 24

coag

Question 25

coag or platelet defects for haemarthrosis?

Answer 25

coag

Question 26

in surgery, you worry more about bleeding in coag or platelet defects

Answer 26

platelet