Epistaxis and Nasal Polyps

Question 1

why is there a predominance of epistaxis during winter months?

Answer 1

1. URIs
2. allergic rhinitis
3. mucosal changes d/t temp and humidity

Question 2

what kind of epistaxis is the most common?

Answer 2

anterior

Question 3

where does anterior epistaxis occur?

Answer 3

kiesselbach plexus

Question 4

epistaxis that can result in severe hemorrhage due to large vessels

Answer 4

posterior epistaxis

Question 5

what to do for patients with posterior epistaxis?

Answer 5

refer to ED or ENT

Question 6

what is the first thing to do for a patient with epistaxis?

Answer 6

ensure airway is clear

Question 7

what should the patient with anterior epistaxis do initially?

Answer 7

blow nose to remove blood or clots

Question 8

after a patient with anterior epistaxis blows their nose, what should the clinician do?

Answer 8

spray nose with Afrin to vasoconstrict

Question 9

what to do after anterior epistaxis has been sprayed with Afrin?

Answer 9

pinch ala for 10 mins and lean forward

Question 10

what do to during a physical exam in a patient with anterior epistaxis?

Answer 10

use a nasal speculum to inspect the kiesselbach plexus

Question 11

what is the treatment for anterior epistaxis that do not stop bleeding with Afrin and pinching? (2)

Answer 11

1. nasal packing
2. cautery - use with caution

Question 12

when should a patient with epistaxis that did nasal packing see an ENT?

Answer 12

24-48 hrs after

Question 13

what is the treatment/management for posterior epistaxis? (2)

Answer 13

1. balloon catheters
2. foley catheters

Question 14

what should I check in a patient with posterior epistaxis? (2)

Answer 14

1. check for blood running down the throat
2. look inside ears for blood behind TM

Question 15

all patients with posterior epistaxis should be referred to ____ or ____

Answer 15

ED
ENT

Question 16

pale, edematous, mucosa-covered masses in the nares or sinuses

Answer 16

nasal polyps

Question 17

nasal polyps are commonly seen in patients with ____ _____

Answer 17

allergic rhinitis

Question 18

a patient presents with a pale, edematous mass that causes chronic nasal obstruction and decreased sense of smell. what are they experiencing?

Answer 18

nasal polyps

Question 19

what is the samter triad?

Answer 19

1. nasal polyp
2. hx of asthma
3. aspirin use that leads to bronchospasms

Question 20

what should I consider if nasal polyps are present in a child?

Answer 20

cystic fibrosis

Question 21

what to do for a patient with nasal polyps?

Answer 21

refer to ENT

Question 22

how will ENT treat a patient with nasal polyps?

Answer 22

intranasal steroids

Question 23

what are 3 intranasal steroids used for nasal polyps?

Answer 23

1. flonase
2. pulmicort
3. nasonex