Epistaxis Flashcards
1
Q
What is it?
A
Bleed in nose/ nasopharynx - either anterior
(usually little’s area/ more common) or exterior
2
Q
Aetiology
A
- Idiopathic
- Infection e.g. rhinitis, sinusitis and nasopharygitis
- Trauma
- Allergy
- Hypertension and atherosclerotic vascular disease
- Hereditary hemoragic telangiectasia
- Blood dyscriasis: abnormal material in the blood (drugs, disease, alcoholism)
- Tumour
- Congenital or acquired nasal defects (e.g. nasal septum)
- Atrophic rhinitis
3
Q
Investigations
A
- Nasal endoscopy
- CT
4
Q
Management
A
- ABCs
- Medical history/medications
- Vital signs (do they need a transfusion)
- Physical exam : anterior rhinoscopy, endoscopic rhinoscopy for posterior bleeds
- Labs
- Nasal packs (application of sterile nasal tampons to the nose)
5
Q
Surgery
A
Ligation
- Internal maxillary
- Sphenopalatine
- Anterior/posterior ethmoidal
- ECA
Embolisation i.e. blocking abnormal vessels
Septodermoplasty and laser ablation
6
Q
What is septodermoplasty?
A
Replace the split skin with a graft
7
Q
Presentation
A
Presence of risk factors
Blood on both sides
8
Q
Risk factors for epistaxis
A
- Dry weather
- Humid
- Presence of foreign bodies
- Digital trauma
- Drugs
9
Q
What is hereditary hemorrhagic telangiectasia
A
Autosomal dominant condition which affects the blood vessels
Treatment:
-Youngs procedure (closes the nasal cavity using mucocutaneous flaps)
-Laser procedure
-Septodermoplasty
10
Q
What is the presentation of an angiofibroma?
A
- one sided epistaxis
- exclusively in males
- Do not biopsy as it is a vascular tumour and will bleed profusely if irritated
- Treat with an embolisation
11
Q
What can cause blood dyschriasis
A
- Drugs
- Disease
- Alcoholism
12
Q
What type of nasal packs are there?
A
- anterior
- posterior
- anterior and posterior
