Epistaxis Flashcards

1
Q

what is Little’s area

A

seen on the anterior portion of the nasal septum using thuddicums speculum

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2
Q

what area accounts for 85% of all epistaxes

A

Little’s area

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3
Q

what is Kiesselbach’s plexus

A

the plexus of vessels in Little’s area: formed by 3 arteries

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4
Q

what 3 arteries form Kiesselbach’s plexus?

A
  • anterior ethmoidal
  • sphenopalatine
  • greater palatine
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5
Q

management if there is a visualised bleeding point

A

cauterise

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6
Q

management if there is not a visualised bleeding point

A

put an anterior pack in

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7
Q

management if there is continuous bleeding despite an anterior pack inserted

A

posterior pack

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8
Q

management following controlled bleeding with either an anterior pack or posterior pack?

A

ward admission for follow up

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9
Q

advice to patients following an epistaxis

A
  • do not blow nose for a week
  • do not clean the nose
  • avoid hot baths/showers
  • let food cool down
  • do not drink hot drinks fro first 72 hours
  • no strenuous exercise for a week
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10
Q

ointment following an epistaxis, and duration

A

Naseptin BD for 1-2 weeks –> to keep nasal cavity lining free of crusts and kept moist

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11
Q

what is the cautery used

A

silver nitrate

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12
Q

how long can posterior packs stay in for without giving abx

A

48 hours

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13
Q

what should be given if a posterior pack is required to be kept in for longer than 48 hours

A

prophylactic oral Abx

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14
Q

3 investigations for a patient with epistaxis?

A
  • bloods: FBC, group + save, coag profile
  • ensure IV access available
  • examine nose w/ thuddicums speculum
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15
Q

most common cause of epistaxis

A

trauma

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16
Q

3 medications in the elderly that can increase risk of epistaxis

A
  • warfarin
  • aspirin
  • clopidogrel
17
Q

nasal pathology risk factors for epistaxis

A
  • Sinonasal malignancy

- SCC in post nasal space

18
Q

cause of nasal vestibule inflammation that could cause epistaxis

A

staphylococcal colonization

19
Q

creams than can reduce inflammation of nasal vestibule through antibacterial properties

A

naspetin
or
bactroban

20
Q

haematological causes of epistaxis

A

ITP
+
DIC

21
Q

iatrogenic cause of epistaxis

A

recent nasal surgery

22
Q

inflammatory causes of epistaxis

A

GPA
+
Sarcoidosis

23
Q

trauma causing epistaxis

A

blunt trauma or nose picking

24
Q

neoplasm of nasal cavity causing epistaxis

A
  • SCC
  • Adenocarcinoma
  • inverted papilloma