<prompt> An 70 yrs. aged patient with epistaxis , patient is hypertensive with B.P 200110 mm Hg. On examination no active bleeding noted, next step of management is:Observation with hypertension controlInternal maxillary artery ligationAnterior and posterior nasal packAnterior nasal pack  <response>: Ans. is a i.e Observation with hypertension control MC cause of epistaxis in elderly is hypertension .In cases of active bleeding it is controlled by anterior or posterior nasal packingArtery ligation is helpful only if bleeding cannot be controlled by conservative measures.Since in this patient there is no active bleeding and further the cause is hypertension the management is observation antihypertensives.Remember:MC cause of epistaxis in children adults - finger nail trauma .MC site of epistaxis is- littles area MC cause of epistaxis in a 15 yr old female- Hematopoietic disorder . 