Epistaxis

Epistaxis

Q. 1

A 55 year old man presented with epistaxis. On investigation, nasopharyngeal cancer was diagnosed. Regarding nasopharyngeal carcinoma,

Assertion: This patient may have ulcerative form of nasopharyngeal cancer

Reason: Because epistaxis is the common symptom of ulcerative type
 

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Q. 1

A 55 year old man presented with epistaxis. On investigation, nasopharyngeal cancer was diagnosed. Regarding nasopharyngeal carcinoma,

Assertion: This patient may have ulcerative form of nasopharyngeal cancer

Reason: Because epistaxis is the common symptom of ulcerative type
 

 A

Both Assertion and Reason are true, and Reason is the correct explanation for Assertion

 B

Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion

 C

Assertion is true, but Reason is false

 D

Assertion is false, but Reason is true

Ans. A

Explanation:

In ulcerative form of nasopharyngeal carcinoma, epistaxis is the common symptom. Proliferative type causes obstructive nasal symptoms. Growth infiltrates submucosally in infiltrative type of carcinoma.

Ref: Diseases of Ear, Nose and Throat By PL Dhingra, 4th Edition, Page 232, 233.


Q. 2

Which artery is responsible for epistaxis after ligation of external carotid artery?

 A

Ethmoidal artery

 B

Greater palatine artery

 C

Ascending pharyngeal artery

 D

Superior labial artery

Q. 2

Which artery is responsible for epistaxis after ligation of external carotid artery?

 A

Ethmoidal artery

 B

Greater palatine artery

 C

Ascending pharyngeal artery

 D

Superior labial artery

Ans. A

Explanation:

Ethmoidal artery is a branch of internal carotid artery while rest of the arteries provided in the options are branches of external carotid arteries, thereby after ligation of external carotid artery, ethmoidal artery is the only artery which can cause epistaxis.


Q. 3

A child was brought to the emergency department with recurrent epistaxis. A detailed history revealed that he had a fall two days before, but he neglected because it didn’t hurt him. Examination shows septal hematoma. Management of septal hematoma is:

 A

Incision and drainage

 B

Wait and watch

 C

Only pressure bandage

 D

All of the above

Q. 3

A child was brought to the emergency department with recurrent epistaxis. A detailed history revealed that he had a fall two days before, but he neglected because it didn’t hurt him. Examination shows septal hematoma. Management of septal hematoma is:

 A

Incision and drainage

 B

Wait and watch

 C

Only pressure bandage

 D

All of the above

Ans. A

Explanation:

Septal hematoma is a complication of direct nasal trauma, often associated with fracture of the nasal septum with or without concomitant nasal bone fracture.

  • Bleeding from submucosal blood vessels leads to an accumulation of blood between the mucoperichondrium and the septal cartilage, which may lead to ischemic avascular necrosis of the underlying cartilage, destruction of the cartilage and saddle deformity of the distal nose. 
  • Prompt incision of the hematoma and drainage through the mucosal surface is necessary.
 

Q. 4

An 70 yrs aged patient with epistaxis , patient is hypertensive with B.P = 200/110 mmHg. On examination no active bleeding noted, next step of management is:

 A

Observation with hypertension control

 B

Internal maxillary artery ligation

 C

Anterior and posterior nasal pack

 D

Anterior nasal pack

Q. 4

An 70 yrs aged patient with epistaxis , patient is hypertensive with B.P = 200/110 mmHg. On examination no active bleeding noted, next step of management is:

 A

Observation with hypertension control

 B

Internal maxillary artery ligation

 C

Anterior and posterior nasal pack

 D

Anterior nasal pack

Ans. A

Explanation:

Q. 5

A middle aged man presented with epistaxis, serous otitis media with hearing loss, and otalgia. He had a history of infectious mononucleosis few weeks earlier. Malignancy was suspected. Which of the following is the commonest nasopharyngeal malignancy?

 A

Adenocarcinoma

 B

Sq.cell tumour

 C

Squamous cell carcinoma

 D

Transitional cell carcinoma

Q. 5

A middle aged man presented with epistaxis, serous otitis media with hearing loss, and otalgia. He had a history of infectious mononucleosis few weeks earlier. Malignancy was suspected. Which of the following is the commonest nasopharyngeal malignancy?

 A

Adenocarcinoma

 B

Sq.cell tumour

 C

Squamous cell carcinoma

 D

Transitional cell carcinoma

Ans. C

Explanation:

Q. 6

Manifestations of vitamin C deficiency are ‑

 A

Pseudoparalysis

 B

Sabre tibia

 C

Epistaxis

 D

a and c

Q. 6

Manifestations of vitamin C deficiency are ‑

 A

Pseudoparalysis

 B

Sabre tibia

 C

Epistaxis

 D

a and c

Ans. D

Explanation:

Ans. is ‘a’ i.e., Pseudoparalysis; ‘c’ i.e., Epistaxis


Q. 7

Which of the following is/are not the features of henoch-Schonlein purpura (HSP) –

 A

Abdominal pain

 B

Splinter hemorrhage

 C

Thrombocytopenia

 D

Epistaxis

Q. 7

Which of the following is/are not the features of henoch-Schonlein purpura (HSP) –

 A

Abdominal pain

 B

Splinter hemorrhage

 C

Thrombocytopenia

 D

Epistaxis

Ans. C

Explanation:

Ans. is ‘c’ i.e., Thrombocytopenia

o HSP is characterized by tetrad of palpable purpura, arthritis, glomerulonephritis and abdominal pain.

o Less common skin lesions are : nonpalpable macules & patches, urticaria, bullous lesions, vesicles, splinter hemorrhage and ulcerations.

o Rarely epistaxis may occur.


Q. 8

A 15-year-old female presented to the emergency department with history of recurrent epistaxis, hematuria and hematochezia. There was a history of profuse bleeding from the umbilicus stump at birth. Previous investigations revealed normal prothrombin time, activated partial thromboplastin time, thrombin time and fibrinogen levels. Her platelet counts as well as platelet function tests were normal but urea clot lysis test was positive. Which one of the following clotting factor is most likely to be deficient

 A

Factor X

 B

Factor XI

 C

Factor XII

 D

Factor XIII

Q. 8

A 15-year-old female presented to the emergency department with history of recurrent epistaxis, hematuria and hematochezia. There was a history of profuse bleeding from the umbilicus stump at birth. Previous investigations revealed normal prothrombin time, activated partial thromboplastin time, thrombin time and fibrinogen levels. Her platelet counts as well as platelet function tests were normal but urea clot lysis test was positive. Which one of the following clotting factor is most likely to be deficient

 A

Factor X

 B

Factor XI

 C

Factor XII

 D

Factor XIII

Ans. D

Explanation:

Ans. is ‘d’ i.e. Factor XIII

o Individuals with a positive bleeding history, particularly with features such as delayed bleeding, umbilical stump bleeding or miscarriages and in whom the initial panel of screening test is negative, should be tested for Factor XIII deficiency.


Q. 9

Aminocaproic acid would be recommended for a hemophilic child with –

 A

Epistaxis

 B

Haematuria

 C

Oral bleeding

 D

a and c

Q. 9

Aminocaproic acid would be recommended for a hemophilic child with –

 A

Epistaxis

 B

Haematuria

 C

Oral bleeding

 D

a and c

Ans. D

Explanation:

Ans. is ‘a’ i.e., Epitaxis; ‘c’ i.e., Oral bleeding

  • Epsilon aminocaproic acid (EACA) and tranexamic acid, inhibitors of fibrinolytic enzyme, inhibit clot lysis and promote the hemostasis in oral bleeds, and other sites e.g., epistaxis.

o In hematuria it is contraindicated. Factor VIII is given, if not controlled prednisolone is given.

o In hemarthrosis, Factor VIII is given.


Q. 10

M/C cause of epistaxis in 3 years old child:

 A

Nasal polyp

 B

Foreign body

 C

Upper respiratory catarrh

 D

Atrophic rhinitis

Q. 10

M/C cause of epistaxis in 3 years old child:

 A

Nasal polyp

 B

Foreign body

 C

Upper respiratory catarrh

 D

Atrophic rhinitis

Ans. C

Explanation:

Q. 11

In a 5-year-old child, most common cause of unilateral epistaxis is:

 A

Foreign body

 B

Polyp

 C

Atrophic rhinitis

 D

Maggot’s

Q. 11

In a 5-year-old child, most common cause of unilateral epistaxis is:

 A

Foreign body

 B

Polyp

 C

Atrophic rhinitis

 D

Maggot’s

Ans. A

Explanation:

Q. 12

Recurrent epistaxis in a 15-year-old female, the most common cause is:

 A

Juvenile nasopharyngeal fibroma

 B

Rhinosporiodiosis

 C

Foreign body

 D

Hematopoietic disorder

Q. 12

Recurrent epistaxis in a 15-year-old female, the most common cause is:

 A

Juvenile nasopharyngeal fibroma

 B

Rhinosporiodiosis

 C

Foreign body

 D

Hematopoietic disorder

Ans. D

Explanation:

Q. 13

Epistaxis in elderly person is common in:

 A

Foreign body

 B

Allergic rhinitis

 C

Hypertension

 D

Nasopharyngeal carcinoma

Q. 13

Epistaxis in elderly person is common in:

 A

Foreign body

 B

Allergic rhinitis

 C

Hypertension

 D

Nasopharyngeal carcinoma

Ans. C

Explanation:

 



Q. 14

Systemic causes of epistaxis are all except:

 A

Hypertension

 B

Anticoagulant treatment

 C

Hereditary telangiectasia

 D

Hemophilia

Q. 14

Systemic causes of epistaxis are all except:

 A

Hypertension

 B

Anticoagulant treatment

 C

Hereditary telangiectasia

 D

Hemophilia

Ans. D

Explanation:

Q. 15

A 70 years aged patient with epistaxis, patient is hyper­tensive with BP = 200/100 mm Hg. On examination no active bleeding noted, next step of management is:

 A

Observation

 B

Internal maxillary artery ligation

 C

Anterior and posterior nasal pack

 D

Anterior nasal pack

Q. 15

A 70 years aged patient with epistaxis, patient is hyper­tensive with BP = 200/100 mm Hg. On examination no active bleeding noted, next step of management is:

 A

Observation

 B

Internal maxillary artery ligation

 C

Anterior and posterior nasal pack

 D

Anterior nasal pack

Ans. A

Explanation:

Q. 16

Source of epistaxis after ligation of external carotid artery is:

 A

Maxillary artery

 B

Greater palatine artery

 C

Superior labial artery

 D

Ethmoidal artery

Q. 16

Source of epistaxis after ligation of external carotid artery is:

 A

Maxillary artery

 B

Greater palatine artery

 C

Superior labial artery

 D

Ethmoidal artery

Ans. D

Explanation:

Q. 17

If posterior epistaxis cannot be controlled, which artery is ligated: 

 A

Posterior ethmoidal artery

 B

Maxillary artery

 C

Sphenopalatine artery

 D

External carotid artery

Q. 17

If posterior epistaxis cannot be controlled, which artery is ligated: 

 A

Posterior ethmoidal artery

 B

Maxillary artery

 C

Sphenopalatine artery

 D

External carotid artery

Ans. C

Explanation:

 

Ligation technique is reserved for intractable bleeding where the source cannot be located or controlled by other techniques.

The hierarchy of arteries used for ligation is:

  • Sphenopalatine artery
  • Internal maxillary artery
  • External carotid Artery
  • Anterior/posterior ethmoidal artery

Earlier the most common artery ligated was maxillary artery but now endonasal sphenopalatine artery ligation (ESPAL) is the ligation of choice



Q. 18

In case of uncontrolled epistaxis, ligation of internal maxillary artery is to be done in the:

 A

Maxillary antrum

 B

Pterygopalatine fossa

 C

At the neck

 D

Medial wall of orbit

Q. 18

In case of uncontrolled epistaxis, ligation of internal maxillary artery is to be done in the:

 A

Maxillary antrum

 B

Pterygopalatine fossa

 C

At the neck

 D

Medial wall of orbit

Ans. B

Explanation:

Q. 19

Treatment of choice in recurrent epistaxis in a patient with hereditary hemotelangiectasis:

 A

Anterior ethmoidal artery ligation

 B

Septal dermatoplasty

 C

External carotid artery ligation

 D

Internal carotid artery ligation

Q. 19

Treatment of choice in recurrent epistaxis in a patient with hereditary hemotelangiectasis:

 A

Anterior ethmoidal artery ligation

 B

Septal dermatoplasty

 C

External carotid artery ligation

 D

Internal carotid artery ligation

Ans. B

Explanation:

 

Hereditary hemotelangiectasia (HHT) or Osler-Weber-Rendu disease is an autosomal dominant condition affecting blood vessels in the skin, mucous membranes and viscera

The genetic abnormality is located to chromosome 9 and 12

Classical features:

  • Telangiectasia
  • AN malformations
  • Aneurysms
  • Recurrent epistaxis (seen in 93% cases)



Q. 20

Causes of epistaxis are all except:

 A

Allergic rhinitis

 B

Foreign body

 C

Tumor

 D

Hypertension

Q. 20

Causes of epistaxis are all except:

 A

Allergic rhinitis

 B

Foreign body

 C

Tumor

 D

Hypertension

Ans. A

Explanation:

 

 Many nasal problems can lead to epistaxis viz nasal trauma, viral rhinitis, chronic infections of nose (which lead to crust formation like atrophic rhinitis, rhinits sicca, TB of nose), foreign bodies in nose (maggots and non living), DNS, neoplasms (hemangioma, papilloma, carcinoma or sarcoma).

Two nasal conditions which donot lead to epistaxis:

  • Nasal polyps
  • Allergic rhinitis

Pharyngeal conditions which lead to epistaxis:

  • Adenoiditis
  • Juvenile angiofibroma
  • Malignant tumors

Q. 21

Posterior epistaxis is commonly seen in: 

 A

Children with ethmoidal polyps

 B

Foreign bodies of the nose

 C

Hypertension

 D

Nose picking

Q. 21

Posterior epistaxis is commonly seen in: 

 A

Children with ethmoidal polyps

 B

Foreign bodies of the nose

 C

Hypertension

 D

Nose picking

Ans. C

Explanation:

 

M/c cause of epistaxis in adults is hypertension

  • M/c site – Woodruff area
  • Causes posterior epistaxis

Q. 22

Posterior epistaxis occurs from:

 A

Woodruffs plexus

 B

Kiesselbach’s plexus

 C

Atherosclerosis

 D

Littles area

Q. 22

Posterior epistaxis occurs from:

 A

Woodruffs plexus

 B

Kiesselbach’s plexus

 C

Atherosclerosis

 D

Littles area

Ans. A

Explanation:

Q. 23

A child with unilateral nasal obstruction along with a mass in cheek and profuse and recurrent epistaxis. Diagnosis is 

 A

Glomus tumor

 B

Antrochoanal polyp

 C

Juvenile nasal angiofibroma

 D

Rhinolith

Q. 23

A child with unilateral nasal obstruction along with a mass in cheek and profuse and recurrent epistaxis. Diagnosis is 

 A

Glomus tumor

 B

Antrochoanal polyp

 C

Juvenile nasal angiofibroma

 D

Rhinolith

Ans. C

Explanation:

Q. 24

Which is known as artery of epistaxis?

 A

Anterior ethmoidal A

 B

Sphenopalatine A

 C

Greater palatine A

 D

Septal branch of superior labial A

Q. 24

Which is known as artery of epistaxis?

 A

Anterior ethmoidal A

 B

Sphenopalatine A

 C

Greater palatine A

 D

Septal branch of superior labial A

Ans. B

Explanation:

Q. 25

A 10 years child has unilateral nasal obstruction epistaxis, swelling over cheek, the diagnosis is:

 A

Nasal polyp

 B

Nasopharyngeal carcinoma

 C

Angiofibroma

 D

Foreign bodies

Q. 25

A 10 years child has unilateral nasal obstruction epistaxis, swelling over cheek, the diagnosis is:

 A

Nasal polyp

 B

Nasopharyngeal carcinoma

 C

Angiofibroma

 D

Foreign bodies

Ans. C

Explanation:

Q. 26

A 15-year-aged boy presents with unilateral nasal blockade mass in the cheek and epistaxis; likely diagnosis is:

 A

Nasopharyngeal Ca

 B

Angiofibroma

 C

Inverted papilloma

 D

None of the above

Q. 26

A 15-year-aged boy presents with unilateral nasal blockade mass in the cheek and epistaxis; likely diagnosis is:

 A

Nasopharyngeal Ca

 B

Angiofibroma

 C

Inverted papilloma

 D

None of the above

Ans. B

Explanation:

This is Typical Presentation of Nasopharyngeal Fibroma/Angiofibroma

  • Nasopharyngeal fibroma is most common benign tumor of nasopharynx.
  • Most common site is posterior part of nasal cavity close to the margin of sphenopalatine foramen.
  • Sex : Seen almost exclusively in males (testosterone dependent).
  • Age : 10-20 years (2nd decade).
  • Clinical features:   – Most common symptom is profuse and recurrent epistaxis Progressive nasal obstruction

Denasal speech

Conductive hearing loss and serous otitis media Mass in nasopharynx

Broadening of nasal bridge

Proptosis

Frog-face deformity

Swelling of cheek

Involvement of cranial nerves II, Ill, IV, VI


Q. 27

A 14 years boy presented with repeated epistaxis, and a swelling in cheek. Which of these statements may be correct?

 A

Diagnosis is nasopharyngeal angiofibroma

 B

Contrast CT scan should be done to see the extent

 C

High propensity to spread via lymphatics

 D

a and b 

Q. 27

A 14 years boy presented with repeated epistaxis, and a swelling in cheek. Which of these statements may be correct?

 A

Diagnosis is nasopharyngeal angiofibroma

 B

Contrast CT scan should be done to see the extent

 C

High propensity to spread via lymphatics

 D

a and b 

Ans. D

Explanation:

Q. 28

A 25 years old female develops serous otitis media of left ear with cough and occasional hemoptysis and . hematuria and epistaxis for one and half months her. Hemoglobin is 7 gm. B.P. > 170/100, ptoreinuria +++, RA positive (+ve) and ANCA positive (+ve), the likely cause is-

 A

Wegener’s granulo matosis

 B

Rheumiatoid arthritis

 C

Rapidly proliferative glomerulonephritis

 D

Good pasteur’s syndrome

Q. 28

A 25 years old female develops serous otitis media of left ear with cough and occasional hemoptysis and . hematuria and epistaxis for one and half months her. Hemoglobin is 7 gm. B.P. > 170/100, ptoreinuria +++, RA positive (+ve) and ANCA positive (+ve), the likely cause is-

 A

Wegener’s granulo matosis

 B

Rheumiatoid arthritis

 C

Rapidly proliferative glomerulonephritis

 D

Good pasteur’s syndrome

Ans. A

Explanation:

Answer is A (Wegener’s granulomatosis):

The patient in question is presenting with the charachteristic triad of Wegener’s granutomatosis namely, vasculitis of the upper respiratory tract (serious otitis media and epistaxis), vasculitis of the lower respiratory tract (hemoptysis) and vasculitis of the kidney (proteinuria)

Presence of ANCA and Rheumatoid factor further support the diagnosis of Wegener’s granulomatosis which is the single best answer of choice.


Q. 29

A 25 years old female develops serous otitis media of left ear with cough and occasional hemoptysis and hematuria and epistaxis for one and half months her hemoglobin is 7 gm. B.P is > 170/100, proteinuria +++, RA – ve and ANCA – ve, the likely cause is‑

 A

Wegener’s granulomatosis

 B

Rheumiatoid arthritis

 C

Rapidly proliferative glomerulonephritis

 D

Goodpasteur’s syndrome

Q. 29

A 25 years old female develops serous otitis media of left ear with cough and occasional hemoptysis and hematuria and epistaxis for one and half months her hemoglobin is 7 gm. B.P is > 170/100, proteinuria +++, RA – ve and ANCA – ve, the likely cause is‑

 A

Wegener’s granulomatosis

 B

Rheumiatoid arthritis

 C

Rapidly proliferative glomerulonephritis

 D

Goodpasteur’s syndrome

Ans. A

Explanation:

Answer is A>D (Wegener’s granulumatosis > Goodpasture’s Syndrome);

The patient in question is presenting with characteristic clinical triad of Wegener’s granulomatosis, namely, Vasculitis of upper respiratory tract (serous otitis media, epistaxis), Vasculitis of lower respiratory tract (cough and hemoptysis) and vasculitis of the kidney (proteinuria)

Although positive ANCA assays are often instrumental in suggesting the diagnosis of WG, Negative ANCA assays do not preclude the diagnosis, 10% of patients with disseminated WG and upto 30% of patients with limited WG may be negative for ANCA

The clinical picture is classical of Wegner’s Granulomatosis. However, the absence of ANCA confuses the diagnosis. Nevertheless the presence or absence of ANCA should be adjunctive and in the presence of a classical clinical picture of WG, tissue diagnosis (biopsy) should be performed to confirm the diagnosis.

Definitive diagnosis of WG is established by tissue biopsy and not by presence or absence of ANCA

Pulmonary + Renal Syndrome
Pulmonary (Hemoptysis) + Renal (Proteinuria) manifestations

Wegener’s granulomatosis

Classical Clinical presentation is one of a young Male/Female (male: female=1:1) presenting with upper respiratory tract features (Otitis media, Epistaxis) along with hemoptysis and acute glomerulonephritis+

ANCA is usually positive and suggests the diagnosis

Negative ANCA does not preclude the diagnosis. In the presence of classical clinical picture a provisional diagnosis of WG should be made on clinical ground and confirmed/ excluded by tissue biopsy

The patient in question is presenting with classical clinical triad of Wegener’s granulomatosis. Although ANCA is negative a negative ANCA does not preclude the diagnosis of WG. Based on the strong clinical suspicion, WG should the single best initial provisional diagnosis and tissue biopsy should be performed.

Goodpasture’s syndrome

 

Classical clinical presentation is one of a young male smoker (male female=3-4:1) presenting with hemoptysis and signs of acute glomerulonephritis

 

Although disease may be preceeded by an upper respiratory tract infection, upper respiratory tract involvement features like otitis media and epistaxis are not characterstic of good pasture’s syndrome

 

ANCA is usually negative

 

Diagnosis is made by detecting serum levels of Anti GBM antibodies

 

The patient in question is not presenting with classical clinical features of good pasture’s syndrome and serum levels of Anti GBM antibodies have not been provided in the question. These make a diagnosis of Good pasture’s syndrome less likely.




Q. 30

A child with unilateral nasal obstruction along with a mass in cheek and profuse & recurrent epistaxis:

 A

Juvenile Nasal angiofibroma

 B

Glomus tumour

 C

Antrochoanal polyp

 D

Rhinolith

Q. 30

A child with unilateral nasal obstruction along with a mass in cheek and profuse & recurrent epistaxis:

 A

Juvenile Nasal angiofibroma

 B

Glomus tumour

 C

Antrochoanal polyp

 D

Rhinolith

Ans. A

Explanation:

 

Nasopharyngeal angiofibroma/ Juvenile nasopharyngeal angiofibroma

  • It is a histologically benign but locally aggressive vascular tumor that grows in the back of the nasal cavity.
  • It most commonly affects adolescent males.
  • Patients with nasopharyngeal angiofibroma usually present with one-sided nasal obstruction and recurrent bleeding.

Q. 31

A 15 year aged boy presents with unilateral nasal blockade,mass in the cheek and epistaxis, the  likely diagnosis is ‑

 A

Nasopharyngeal carcinoma

 B

Nasopharyngeal Angiofibroma

 C

Inverted papilloma

 D

None of the above

Q. 31

A 15 year aged boy presents with unilateral nasal blockade,mass in the cheek and epistaxis, the  likely diagnosis is ‑

 A

Nasopharyngeal carcinoma

 B

Nasopharyngeal Angiofibroma

 C

Inverted papilloma

 D

None of the above

Ans. B

Explanation:

 

Recurrent epistaxis, nasal obstruction and swelling over cheek in a 15 years boy suggest the diagnosis of nasopharyngeal angiofibroma.

Juvenile nasopharyngeal angiofibroma (JNA) is a benign, but locally aggresive, tumor of nasopharynx seen in prepubertal and adolescent males. It is the most common benign neoplasm of nasopharynx. It is a highly vascular tumor and blood supply of the tumor most commonly arises from the internal maxillary artery. Juvenile nasopharyngeal angiofibroma (JNA) occurs almost exclusively in males. Female with Juvenile nasopharyngeal angiofibroma (JNA) should undergo genetic testing. Onset is most commonly in the second decades, the range is 7-19 years.

The exact cause is unknown. As the tumour is predominantly seen in adolescent males in the second decade of life, it is thought to be testosterone dependent.

Such patients have a hamartomatous nidus of vascular tissue in the nasopharynx and this is activated to form angiofibroma when male sex hormone appears.


Q. 32

Rhinolith can cause 

 A

Nasal obstruction

 B

Epistaxis

 C

Epiphora

 D

All of the above

Q. 32

Rhinolith can cause 

 A

Nasal obstruction

 B

Epistaxis

 C

Epiphora

 D

All of the above

Ans. D

Explanation:

A rhinolith is a calculus present in the nasal cavity.

The word is derived from the roots rhino- and -lith, literally meaning “nose stone”. 

A rhinolith usually forms around the nucleus of a small exogenous foreign body, blood clot or secretion by slow deposition of calcium and magnesium salts.

Over a period of time, they grow into large irregular masses that fill the nasal cavity.

They may cause pressure necrosis of the nasal septum or lateral wall of nose leading to nasal obstruction, epistaxis, headache, sinusitis and epiphora.



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