Epistaxis

Question 1

Where do 95% of nosebleeds originate

Answer 1

Kiesselbachs plexus

Question 2

The aetiology

Answer 2

Idiopathic 85%
Local: Mucusal irritation, tumours, local vascular congestion
Systemic: Bleeding disorders, neoplasms, inflammatory disorders, hypertension

Question 3

What is HHT

Answer 3

Hereditary Haemorhagic Telangectasia

Nosebleeds, go bleeds, malformations of lung and brain

Question 4

Wegeners Granulomatosis

Answer 4

Necrotising inflammation of small vessels
Upper airway, lung and kidney,
Nose bleeds, septal perforation, Haemoptosys and haematuria
1/100,000

Question 5

Relevant HX

Answer 5

Blood thinners, previous nasal surgery, trauma, anterior nose bleeds (running out of the nostrils) vs posterior (running down throat)
Juvenile nasopharyngeal angiofibroma - nasal obstruction, headaches, rinnohrea and anosmia

Question 6

Class one hemorrahage

Question 7

Class 2 hemorrahage

Answer 7

15-30%

Question 8

Class 3 hemorrahage

Answer 8

30-40

Question 9

Class 4 hemorrahage

Answer 9

> 40%