**History and Physical Report**

**Patient Overview:**
- The patient is a well-developed, muscular, slightly pale young man in somewhat acute distress due to apprehension and bleeding.

**Vital Signs:**
- Blood Pressure: 110/70
- Pulse: 74
- Respirations: 16

**HEENT:**
- **Head:** Normocephalic
- **Eyes:** Round, regular, equal, and react to light and accommodation bilaterally
- **Ears:** Bilateral cerumen, TMs are normal
- **Nose:** Right nasal cavity somewhat congested to the nasopharynx; active bleeding from the left nasal cavity
- **Neck:** No palpable nodes, thyroid is midline

**Chest:**
- Symmetric with normal male breasts
- Lungs clear bilaterally, no rales or wheezes
- Left anterolateral chest pneumonectomy scar

**Heart:**
- Normal in size
- Normal sinus rhythm, no murmurs, thrills, or rubs

**Abdomen:**
- Soft, no tenderness

**Rectal Exam:**
- Deferred

**Extremities:**
- Symmetrical, no cyanosis, edema, or deformities
- Normal range of motion

**Neurological:**
- Reflexes are physiological
- Pulses are two plus and equal bilaterally
- No cranial or neurological deficit

**Impression:**
- Left posterior epistaxis, recurrent