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Chapter: 4 / Q: 61
A 16-year-old girl attends her GP complaining of worsening dysmenorrhoea. She notes that the pain associatedwith her period has gradually been worsening and she has also noticed worsening bleeding. She denies any risk factors for venousthrombosis
Chapter: 4 / Q: 62
A 37-year-old lady has recently entered into a new relationship. She had previously not relied on any hormonal contraception as she had used barrier methods for interactions with casual partners. She is clinically obese and is a heavy smoker, she has no past history of venous thrombosis
Chapter: 4 / Q: 63
A 21-year-old girl seeks help from her GP. She has a regular partner and normally uses the combined oral contraceptive pill for protection. More recently she has suffered with a diarrhoeal illness that has resolved. She had sex with her regular partner the night before but has since started
Chapter: 4 / Q: 64
A 22-year-old medical student has been advised that she should change her contraceptive. She is currently using the combined oral contraceptive pill but at her regular follow-up appointment she is told that her blood pressure is too high to be issued with a repeat prescription
Chapter: 4 / Q: 65
A 37-year-old multiparous woman has attended the GP practice to discuss contraceptive options. She has used combined oral contraceptives in the past but since having her last child has decided that she wants a more reliable option
Chapter: 4 / Q: 66
A 64-year-old woman presents to accident and emergency with a month’s history of progressive difficulty in swallowing, especially for solid food with associated regurgitation of food. She has noticed when she vomits that there are often bright red streaks of blood mixed with the food
Chapter: 4 / Q: 67
A 34-year-old accountant presents to hospital on a Friday night with a history of vomiting, severe retching and haematemesis of two cupfuls of fresh blood. He is intoxicated and is pale, anxious and there is bloodstaining around his mouth. His colleagues tell you that they were at a social event
Chapter: 4 / Q: 68
A 54-year-old man is brought in by ambulance to accident and emergency after collapsing at his home 10 minutes away from the hospital. On arrival he looks pale with a Glasgow Coma Scale (GCS) of 6 and there is bloodstaining down his shirt, trousers and around his mouth. He is breathing heavily
Chapter: 4 / Q: 69
A 43-year-old woman is 3 days post-laparoscopic gastric bypass for morbid obesity. The nurses call you early in the morning as she started to bring up dark red blood with intermittent bouts of vomiting. A sample of the vomitus has been kept and you notice a characteristic heavily dark brown
Chapter: 4 / Q: 70
A 58-year-old man presents to his GP with a 6-week history of feeling tired at work and inability to sleep well at night. On further questioning he says that he has been not able to tolerate food well recently with severe vomiting after meals and more recently small flecks of blood mixed
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