Nose and paranasal sinuses: management of anterior 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 and paranasal sinuses: management of anterior epistaxis

Sample item

A healthy adult has recurrent anterior nosebleeds. After pressure on the soft part of the nose for 10 minutes, a bleeding vessel is seen on the anterior septum. What is the next step?

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

The answer and the reasoning

D. Chemical cautery of the vessel with silver nitrate after local anaesthesia

A visible anterior septal bleeding point in Little's area can be treated by cautery after topical vasoconstrictor and anaesthetic. Chemical cautery with silver nitrate is applied to a small area, and bilateral septal cautery is avoided to prevent perforation. Packing is the next step if cautery fails.

Option by option

  • A. Posterior nasal pack

    A posterior pack is for posterior bleeding that cannot be controlled otherwise.

  • B. Ligation of the anterior ethmoidal artery

    Arterial ligation is a surgical option for refractory bleeding.

  • C. Embolisation of the sphenopalatine artery

    Embolisation is reserved for severe or refractory posterior bleeding.

  • D. Chemical cautery of the vessel with silver nitrate after local anaesthesia (correct)

    Correct. Targeted cautery of a visible bleeder is simple and effective.

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, Chemical cautery of the vessel with silver nitrate after local anaesthesia. A visible anterior septal bleeding point in Little's area can be treated by cautery after topical vasoconstrictor and anaesthetic.

Why is "Posterior nasal pack" not the answer?

A posterior pack is for posterior bleeding that cannot be controlled otherwise.

Why is "Ligation of the anterior ethmoidal artery" not the answer?

Arterial ligation is a surgical option for refractory bleeding.

Why is "Embolisation of the sphenopalatine artery" not the answer?

Embolisation is reserved for severe or refractory posterior bleeding.

What concept does this question test?

It tests Nose and paranasal sinuses: management of anterior epistaxis in ENT. Chemical cautery with silver nitrate is applied to a small area, and bilateral septal cautery is avoided to prevent perforation. Packing is the next step if cautery fails.

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 and paranasal sinuses: management of anterior 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.