Stomach, Bowels And Bits

Question 1

A 57-year-old woman is on her 2nd cycle of Kliofem® (estradiol 2 mg, norethisterone aetate 1 mg) to treat her menopausal symptoms. Her last menstrual period was 17 months ago and her uterus is intact. She asks to buy ibuprofen as she has an unusually severe headache.

Which one of the following is the most appropriate course of action to take for this woman?

• advise her to have a 7-day break from Kliofem®
• advise her to monitor her blood pressure daily
• advise her to purchase paracetamol instead
• advise the patient to discontinue Kliofem® and make an appointment to see GP
• advise the patient to see GP and recommend GP switches from her Kliofem® to Premarin® (conjugated oestrogens 300 micrograms)

Answer 1

advise the patient to discontinue Kliofem® and make an appointment to see GP

Question 2

The 32-year-old woman sees your advice as she’s complaining of feeling tired all the time (for about three months) and irritable. She is generally well and healthy but lead to stressful life working long hours for an IT company. She has irritable bowel syndrome and heavy menstrual bleeding but it’s not on any regular medication. She has a BMI of 29

Which one of the following is the most likely cause of this patient symptoms?

• depression
• Insomnia
  -Iron deficiency anaemia
• Lack of thyroid hormone
• Lack of vitamin B-12

Answer 2

Iron deficiency anaemia