Epistaxis: The Daily PANCE Blueprint

The answer is E. Kiesselbach plexus

Epistaxis is a common complaint, encountered both in outpatient and inpatient settings. Causes include infectious, inflammatory, traumatic, coagulopathic, and medication related. Most of the time, nosebleeds are anterior and occur due to bleeding of the Kiesselbach plexus. These are more benign and are easier to manage / achieve hemostasis. On the other hand, posterior nosebleeds are more serious and often require hospitalization. Posterior nose bleeds are most commonly due to bleeding of the sphenopalatine artery; however, often the source of the bleed is hard to identify. First-line management is compressive therapy. Other options include Afrin spray, application of cotton soaked in oxymetazoline, silver nitrate, nasal packing, balloon catheter, etc.