Q:

A 23 year old presents with vomiting, nausea and dizziness. She says her menstrual period has been delayed 4 weeks as she was stressed recently. There are no symptoms present. What is the next appropriate management?

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A 23 year old presents with vomiting, nausea and dizziness. She says her menstrual

period has been delayed 4 weeks as she was stressed recently. There are no

symptoms present. What is the next appropriate management?


  1. Refer to OP psychiatry
  2. Refer to OP ENT
  3. CT brain
  4. Dipstick for B-hCG
  5. MRI brain

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The key is D. Dipstick for B-hCG. [Likely diagnosis is pregnancy. Features like vomiting, nausea and

dizziness are consistent with early pregnancy supported by delayed menstruation].

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