40 year old teacher

PC: abdominal pain

HPC: woke up at 3 am with sharp, stabbing pain in right iliac fossa

coming in waves, associated with nausea

radiating to right groin and loin

dysuria and pain when opening bowels

passed watery diarrhoea x1

started shivering just now

took Tramadol 2 hours ago

PMH: pancreatitis 1997 (due to alcohol excess, now cut down intake)

Hep B 1995 (was jaundiced for 3 weeks)

Syphilis 1980 (fully treated)

patchy alopecia (mainly occipital but also left parietal)

cholelithiasis since 1999 (usually asymptomatic)

DHx: Aspirin 75 mg od

Paracetamol for "aches and pains"

beta-blocker

party drugs (none recently)

NKDA

FHx: father: unknown

mother: SLE (systemic lupus erythromatosus

brother: schizophrenia

grandmother: blind and deaf

SHx: lives with boyfriend

multiple sexual partners (male and female)

smoker (about 4 cigarettes per day)

social drinker