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Epistaxis (Nosebleeds) (ALL)
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1. What is the most common site of epistaxis in the nose?
*
Kiesselbach's plexus
Middle turbinate
Cribriform plate
Inferior meatus
2. Which of the following is a first-aid measure for epistaxis?
*
Tilt head back
Pinch soft part of nose and lean forward
Apply ice to the feet
Lie down flat
3. Which medical condition increases the risk of epistaxis?
*
Diabetes •
Hypertension
Asthma
Hypothyroidism
4. Which of the following medications increases epistaxis risk?
*
Paracetamol
Beta-blockers
Aspirin
Proton pump inhibitors
5. How long should pressure be applied to control anterior epistaxis?
*
10–15 seconds
1–2 minutes
5–10 minutes
At least 10–15 minutes
6. What should be avoided in the first 24 hours after a nosebleed has stopped?
*
Sleep
Breathing through the nose
Hot drinks
Reading
7. When should urgent ENT referral be made for epistaxis?
*
If the patient is over 60
If it lasts more than 2 minutes
If bleeding is profuse and unresponsive to pressure or packing
If the patient is allergic to nasal sprays
8. Which nasal spray can help control minor epistaxis?
*
Steroid spray
Decongestant spray
Antihistamine spray
Saline spray
9. What is a potential complication of posterior epistaxis?
*
Sinusitis
Airway obstruction
Migraine
Earache
10. What nasal structure is typically cauterised in recurrent anterior epistaxis?
*
Inferior turbinate
Middle turbinate
Little’s area
Frontal sinus
11. Which technique is used if nasal cautery is performed?
*
Electrocautery
Cryotherapy
Silver nitrate stick
Laser ablation
12. What advice should be given after nasal cautery?
*
Pick nose to remove scabs
Avoid blowing nose for several days
Apply pressure frequently
Use intranasal steroids immediately
13. Which factor increases the likelihood of posterior rather than anterior epistaxis?
*
Young age
Minor trauma
Pain on one side only
Bleeding from both nostrils
14. Which of the following would be part of assessing epistaxis?
*
ECG
ESR
Blood glucose
Hb and clotting factor
15. Which comorbidity is particularly concerning in persistent epistaxis?
*
Atrial fibrillation on anticoagulants
Hyperthyroidism
GORD
Acne
16. When might nasal packing be required in epistaxis?
*
If cautery fails or is inappropriate
For mild nosebleeds only
To test for allergies
To treat congestion
17. Which symptom suggests significant blood loss from epistaxis?
*
Dizziness
Dry throat
Rhinophyma
Tinnitus
18. What is an appropriate preventative measure for frequent minor nosebleeds?
*
Petroleum jelly
Swimming clip
Antihistamine tablets
Avoid eating spicy food
19. What is the first step in managing active epistaxis in primary care?
*
Apply direct pressure and assess severity
Call 999 immediately
Start antibiotics
Refer for CT-head
20. Which allergy must be checked before prescribing naseptin cream (Chlorhexidine with neomycin)?
*
Peanut
Shellfish
Strawberry
Penicillin