Allergic Rhinitis, Epistaxis

Question 1

What is allergic rhinitis?

Answer 1

An inflammatory disorder of the nose where the nose become sensitised to allergens such as house dust mites and grass, tree and weed pollens.

Question 2

Features of allergic rhinitis?

Answer 2

• sneezing
• bilateral nasal obstruction
• clear nasal discharge
• post-nasal drip
• nasal pruritus

Question 3

Mx od allergic rhinitis?

Answer 3

1) allergen avoidance

2) oral or intranasal antihistamines

3) intranasal steroids

4) oral steroids

Question 4

What can epistaxis be split into?

Answer 4

Anterior & posterior bleeds

Question 5

Cause of anterior epistaxis?

Answer 5

Usually has a visible source of bleeding.

Occurs due to an insult to the network of capillaries that form Kiesselbach’s plexus.

Question 6

Does anterior or posterior epistaxis often have a visible source of bleeding?

Answer 6

Anterior

Question 7

Does anterior or posterior epistaxis tend to be more profuse?

Answer 7

Posterior - originate from deep structures

Question 8

Risks of a posterior epistaxis?

Answer 8

Risk of aspiration and airway compromise

Question 9

Give some causes of epistaxis

Answer 9

1) benign

2) trauma to nose

3) insertion of foreign bodies

4) bleeding disorders:
- immune thrombocytopenia
- Waldenstrom’s macroglobulinaemia

5) juvenile angiofibroma

6) cocaine use

7) hereditary haemorrhagic telangiectasia

8) granulomatosis with polyangiitis

Question 10

What is a juvenile angiofibroma?

Answer 10

benign tumour that is highly vascularised

seen in adolescent males

Question 11

Typical age of onset of otosclerosis?

Answer 11

15-45 y/o