Paula Peacock
57 year old secretary
PC: epistaxis
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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
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PMH: hypercholesterolaemia
TIA 4 years ago
angina on exertion (>4 flights of stairs)
recurrent otitis media in childhood
hay fever
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DHx: aspirin od
GTN spray prn (= pro re nata; when needed)
antihistamines prn
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FHx: father: umbilical hernia repair 15 years ago with subsequent ileus
mother: mesothelioma due to occupational asbestos exposure
brother: achondroplasia
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SHx: lives with husband
recent travel to Zambia, stayed in hotels mainly
smokes 7-10 cigarettes per day, social drinker