epistaxis

Question 1

more common in

Answer 1

anterior

Question 2

another name for anterior

Answer 2

little’s area
locus kisselbach
locus valsavae

Question 3

another name for posteror

Answer 3

retrocolumellar vein

spenopalatine artery

Question 4

location of little’s area

Answer 4

anterior one third of nasal septum

Question 5

vessels in little’s area

Answer 5

• Anterior Ethmoidal artery..op - Posterior Ethmoidal artery - Sphenopalatine artery..max - Greater Palatine artery..imax - Superior Labial artery…f

Question 6

two main types of epitaxis

Answer 6

congenital

acquired

Question 7

causes under congenital

Answer 7

1. Osler - Rendu - Weber Syndrome( Congenital Teleangectasis )
2. Congenital Blood Coagulation disorders

Question 8

congenital
OWR
Two types with chromosome defect

Answer 8

Type 1: Chromosome 9

Type 2: Chromosome 12

Question 9

congenital
blood coagulation disorders
types with deficiency

Answer 9

a. Classical Haemophilia - this is a sex-linked recessive trait due to deficiency of Factor VIII .
b. Para-haemophilia - this is an autosomal recessive disorder due to deficiency of Factor V .

Question 10

management of congenital epistaxis

Answer 10

1. Steroids - Oestrogens
2. Septal dermoplasty - this is a surgical procedure of implanting part of a generalized skin graft into the nose.

Question 11

causes under acquired

Answer 11

• local conditions
• acute inflammatory conditions
• Chronic inflammatory conditions
• Irritation from inhalation of chemical fumes
• Neoplasms
• Environmental changes
• Generalised disease( a and h)
• diseases of blood
• conditions of organ failure

Question 12

which prodromal stage of certain infectious disease present with epistaxis

Answer 12

Diphtheria
Measles
Varicella
Chicken pox

Question 13

vicarious menstruation

Answer 13

bleeding from a surface other than the mucous membrane of the uterine cavity that occurs at the time when normal menstruation should take place.
his is due to an ectopic implantation of an endometrial tissue into the nose.
The surging estrogen levels in the blood stream can cause the vessels in the nose to fill up, which leads to nosebleeds.

Question 14

investigations

Answer 14

1. Haemogram :
   Hb. PCV . ESR . Platelets .
   Bleeding / Clotting time .
   WBC - Total / Differentials .
2. Radiological:
   X - Ray Sinuses .
   CT Scan head

Question 15

management

Answer 15

first aid( pinching, setting up iv line, monitor vital signs)
- Nasal packing( A and P)

MEDICAL
Antibiotics -
Analgesics
I  V  Fluids 
Sedative / Tranquillizer    eg,   Inj.  Diazepam.

CAUTERIZATION
1. Thermal cauterization - using an electric diathermy .

2. Chemical cauterization - using a sclerosant agent eg, Silver nitrate solution . Trichloroacetic acid.

SURGICAL
Arterial ligation .

Internal Maxillary artery .
Anterior Ethmoidal artery

Question 16

Complications

Answer 16

Hypovolemic shock
Anaemia
Aspiration pneumonia
Infection
Airway obstruction
Myocardial infarction