Epistaxis

Question 1

local causes

Answer 1

idiopathic
trauma
foreign body
inflammation
tumour

Question 2

systemic causes

Answer 2

drugs e.g. warfarin, aspirin
clotting abnormalities
liver disease
haemophilia
leukaemia
thrombocytopenia
arteriosclerosis
hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu)
systemic inflammatory conditions
Wegener's granulomatosis
hypertension

Question 3

acute management of epistaxis

Answer 3

resuscitate patient (consider elderly and cardiovascular disease and potential for hypovolaemia and shock)

Question 4

local management of epistaxis

Answer 4

external pressure to nose
ice
cautery
nasal packing

Question 5

distant management of epistaxis

Answer 5

ligation of arteries supplying Little’s area

Question 6

systemic management of epistaxis

Answer 6

reversal of anticoagulants
correction of clotting abnormalities
platelet transfusion
treatment of hypertension
rare systemic causes managed