Haematology
Case 23: A Patient with Heavy Periods
CASE
A 36‐year‐old solicitor presents to her GP with a 5‐month history of increasingly heavy periods which now regularly soak through her sanitary towels. She has suffered from the occasional nose bleed since she was a teenager and also complains of intermittent gum bleeding for many years. She has no other symptoms but does have a history of hypertension, for which she was started on lisinopril 3 years ago. On direct questioning, her mother once bled heavily after childbirth, requiring a blood transfusion but the patient herself has never had any children and has never had an operation. Physical examination was entirely unremarkable. A full blood count comes back with the following results:
Hb 11.7 g/dL WCC 5.8 × 109/L Platelets 15 × 109/L
APTT, PT, blood film examination, biochemistry and autoantibody screen were all unremarkable.
QUESTION 1
Your score this session: 0 of 0
Which of her symptoms is most suggestive of an underlying platelet disorder?