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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)




Drug history

Warfarin  4mg OD

Verapamil 120mg BD




Social history 

Retired carpenter 


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 




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

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