Epistaxis

Question 1

Most common site of bleeding for epistaxis

Answer 1

Kiesselbach plexus

Question 2

MCC of epistaxis

Answer 2

nose picking
foreign body in nasal cavity
dry nose

Question 3

what genentic condition may cause recurrent epistaxis

Answer 3

hereditary hemorrhagic telangiectasia

Question 4

Causes of epistaxis

Answer 4

Local causes: Nasal irritation
Nose picking (most common cause)
Foreign intranasal body
Dry nose (rhinitis sicca)
CPAP therapy
Excessive nose blowing
Intranasal drug use (e.g., cocaine, topical corticosteroids)
Vascular malformations
Hereditary hemorrhagic telangiectasia (HHT)
Nasal hemangioma
Inflammatory/granulomatous disorders
Allergic rhinitis
Bacterial sinusitis
Rhinosporidiosis
Craniofacial trauma
Blunt trauma (e.g., a fist punch to the nose)
Nasal and septal fractures
Zygomatic, maxillary, or frontal bone fracture
Basal skull fractures
Nasal septal defects
Deviated nasal septum
Septal spurs
Septal perforation
Tumors of the nasopharynx and/or paranasal sinuses
Juvenile nasopharyngeal angiofibroma
Squamous cell carcinoma

Systemic causes:
Bleeding disorders
Von Willebrand disease
Severe thrombocytopenia (e.g., ITP, leukemia, dengue)
Hemophilia
Anticoagulant and/or aspirin therapy
Vascular causes
Hypertension
Granulomatosis with polyangiitis
Carotid artery aneurysm

Question 5

Types of epistaxis

Answer 5

Anterior and posterior

Question 6

Clin F of anterior epistaxis

Answer 6

bleeding from the nostrils

Question 7

Clinf of posterior epistaxis

Answer 7

Blleding down the throat- may have hemoptysis, hematemesis or melena if swallowing large amounts

Question 8

MC type of epistaxis

Answer 8

anterior

Question 9

Peak incidence of anterior epistaxis

Answer 9

children <10yo

Question 10

Peak incidence of posterior epistaxis

Answer 10

> 50yo

Question 11

Mc site of bleeding for anterior epistaxis

Answer 11

Kiesselbach plexus

Question 12

MC site of bleeding for posterior epistaxis

Answer 12

Woodruff plexus

Question 13

Acute management of epistaxis

Answer 13

ABCDE approach

Bilateral pressure for 15–20 minutes

Bleeding site identified: topical vasoconstrictors and/or cautery

Persistent bleeding or unclear bleeding site: nasal packing

Nasal packing unsuccessful: ENT consult

Analgesia and local anesthesia as needed

Anterior epistaxis: Discharge if hemostasis is successful.

Posterior epistaxis: Admit for monitoring.