An 85-year-old hypertensive man is evaluated in the emergency department for recent onset epistaxis. His blood pressure is 150/80 mm Hg, and hematocrit is 39%. What is the most likely source of bleeding?
Correct Answer: Posterior nasal septum
Description: Epistaxis in children and young adults usually arises from the anterior nasal septum (Kiessel bach's plexus). In elderly persons, however, spontaneous rupture of a sclerotic blood vessel in the posterior nasal septum is usually the cause of bleeding, especially in combination with hypertension.
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