Paula Peacock

57 year old secretary

 

PC:      epistaxis

HPC:    nose bleed started 3 days ago

            settled initially after applying pressure to nose

            5 episodes over last days

            cold packs and bending head back did not help

            today she vomited x1: dark blood seen in vomit

            now she is worried that she might have lost a lot of blood

PMH:   hypercholesterolaemia

            TIA 4 years ago

            angina on exertion (>4 flights of stairs)

            recurrent otitis media in childhood

            hay fever

DHx:    aspirin od                                        

            GTN spray prn (= pro re nata; when needed)

            antihistamines prn

FHx:     father: umbilical hernia repair 15 years ago with subsequent ileus

            mother: mesothelioma due to occupational asbestos exposure

            brother: achondroplasia

SHx:    lives with husband

            recent travel to Zambia, stayed in hotels mainly

            smokes 7-10 cigarettes per day, social drinker