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Old 06-03-2012
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Question Intermittent Nosebleeds

A 75-year-old man has a 1-month history of intermittent nosebleeds that occur from either naris. Last night, he experienced a more severe episode. There is no history of trauma to the nose, bleeding disorders, recent upper respiratory tract infections, or recent use of nasal decongestants. The patient uses tissues to remove scabs and mucus from his nares. He has been using his home heater more often because of unusually cold weather. Medical history is significant for hypertension. Current medications are hydrochlorothiazide, atenolol, and low-dose aspirin. Vital signs are normal. No bleeding site is identified in either naris, and examination of the ears, nose, and throat is normal. Which of the following is the best treatment?

A Cauterization of the anterior septum bilaterally
B Intranasal fluticasone
C Oxymetazoline spray
D Packing of one or both anterior nares
E Topical petrolatum and home humidification
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Old 06-03-2012
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no idea but guess is A...........
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Old 06-03-2012
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Quote:
Originally Posted by Novobiocin View Post
A 75-year-old man has a 1-month history of intermittent nosebleeds that occur from either naris. Last night, he experienced a more severe episode. There is no history of trauma to the nose, bleeding disorders, recent upper respiratory tract infections, or recent use of nasal decongestants. The patient uses tissues to remove scabs and mucus from his nares. He has been using his home heater more often because of unusually cold weather. Medical history is significant for hypertension. Current medications are hydrochlorothiazide, atenolol, and low-dose aspirin. Vital signs are normal. No bleeding site is identified in either naris, and examination of the ears, nose, and throat is normal. Which of the following is the best treatment?

A Cauterization of the anterior septum bilaterally
B Intranasal fluticasone
C Oxymetazoline spray
D Packing of one or both anterior nares
E Topical petrolatum and home humidification
e? he is currently not bleeding so D is wrong
B and C will add to his HTN

A cant be done because source cant be seen.
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Old 06-03-2012
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- moisturizing by E.
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Old 06-03-2012
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A. The pt is not actively bleeding.
B. Steroids can infact cause epistaxis.
C. No h/o of rhinorrhea or blocked nose
D. Its done in case of continuous bleeding when cautery is not successful or possible.

E should be the answer.
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