50 year old architect

PC: weight loss and jaundice

HPC: lost about 12 kg over last 6 months despite energy drinks

jaundice noticed by wife 10 days ago

loss of appetite

pale stool and dark urine

feeling weak and nauseated

reports frequent gum bleeding, bruising easily

no pain

PMH: suspected sarcoid 10 years ago

G6PD deficiency

Grave's disease

right facial palsy 5 years back, now resolved

DHx: fish oil extracts

benzodiazepine for night sedation

didn’t tolerate chloroquine malaria prophylaxis (G6PD deficiency)

FHx: mother: died of pulmonary embolism

father: rheumatic fever

brother: ankylosing spondylitis

SHx: lives with wife (married for 32 years) and 2 children

smokes 5-10 cigarettes per day

occasional alcohol