Nose: tranexamic acid for epistaxis: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Nose: tranexamic acid for epistaxis

Sample item

A patient on aspirin has an anterior epistaxis that persists after 15 minutes of correct firm pinching. Which topical measure may be tried before cautery or packing?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Cotton pledgets soaked in topical tranexamic acid or vasoconstrictor applied in the nose

Topical tranexamic acid, an antifibrinolytic, applied on a pledget or by spray has been shown to reduce the need for packing in anterior epistaxis. Topical vasoconstrictors with local anaesthetic also help identify and cauterise the bleeding point. Lying back risks swallowing blood and aspiration.

Option by option

  • A. Cold water gargle

    Gargling does not control nasal bleeding.

  • B. Lying flat with the head back

    A head-back position is harmful.

  • C. Oral vitamin K only

    Vitamin K does not treat aspirin-related platelet dysfunction.

  • D. Cotton pledgets soaked in topical tranexamic acid or vasoconstrictor applied in the nose (correct)

    Correct. Topical antifibrinolytic or vasoconstrictor is a useful adjunct.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Cotton pledgets soaked in topical tranexamic acid or vasoconstrictor applied in the nose. Topical tranexamic acid, an antifibrinolytic, applied on a pledget or by spray has been shown to reduce the need for packing in anterior epistaxis.

Why is "Cold water gargle" not the answer?

Gargling does not control nasal bleeding.

Why is "Lying flat with the head back" not the answer?

A head-back position is harmful.

Why is "Oral vitamin K only" not the answer?

Vitamin K does not treat aspirin-related platelet dysfunction.

What concept does this question test?

It tests Nose: tranexamic acid for epistaxis in ENT. Topical vasoconstrictors with local anaesthetic also help identify and cauterise the bleeding point. Lying back risks swallowing blood and aspiration.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nose: tranexamic acid for epistaxis?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.