Virtual Patients - Rhinology - Epistaxis

A 65-year-old man presents to A&E with a large volume left sided epistaxis. It began spontaneously and has persisted for the last 2 hours despite good first aid measures. The patient is also complaining he can taste blood in his mouth and on two occasions has coughed up blood clots. 

 

Past medical history 

Atrial fibrillation (AF)

Hypertension

Osteoarthritis

 

Drug history

Warfarin  4mg OD

Verapamil 120mg BD

 

NKDA

 

Social history 

Retired carpenter 

Ex-smoker 

Does not drink alcohol

 

On examination

The patient is alert

Pulse 100bpm BP 185/95 

Respiratory rate 20

Oxygen saturation 100% on air

 

Nasal examination reveals the following finding on the anterior aspect of the left nasal septum 

Question

 

Which of the following descriptions best describes your nasal examination findings?