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Epistaxis

Question
11 out of 24
 

Epistaxis in elderly person is common in: (LQ)



A Foreign body

B Allergic rhinitis

C Hypertension

D Nasopharyngeal carcinoma

Ans. C Hypertension Ref. Maqboolll th/ed p 180;

According to Scott Brown 7th/ed Vol 2 p 1600 - M/C cause of adult epistaxis is idiopathic though a number of factors increase its chances like use of NSAIDs and alcohol. It further says there is no proven association between hypertension and adult Epistaxis, but still

"Elevated blood pressure is observed in almost all epistaxis admissions. This apparent hypertension in acute admissions may be a result of anxiety associated with hospital admission and the invasive techniques used to control the bleeding." -Dhingra 6th/ed p 167 But still the answer to this question is hypertension by ruling out other options:

Option a - foreign body - is a cause of epistaxis in children and not in elderly age group

Option b - allergic rhinitis - does not lead to epistaxis -Dhingra 5th/ed p 181

Nasopharyngeal carcinoma does cause epistaxis and is seen in elderly age group but is not the most common cause as in itself nasopharyngeal carcinoma is not common.

"Nasal tumors seldom present as epistaxis in isolation Juvenile nasopharyngeal angiofibroma and hemangiopericytoma are rare vascular tumors which can present with severe or recurrent epitaxis in association with nasal obstruction." -Dhingra 5th/ed p 263

Hence our answer by exclusion is hypertension.

The answer is further supported by Maqbool 11 th/ed p 180 which says:

"Hypertension is a very common disease and causes epistaxis frequently in elderly patients."

Epistaxis Flashcard List

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