Biomedical Science A&E with haematemesis and melaena case Study

A 64 year old female presents to A&E with haematemesis (vomiting blood) and melaena (passing of black stools). The doctor takes a brief medical history and notes a sudden onset of symptoms. The patient has no history of bleeding and has been otherwise fit and well. The patient had been experiencing intermittent nose bleeds for around one month, but the haematemesis and melaena had presented about one week ago. The patient has no history of recreational drug use and admits to consuming one large glass of wine twice a week. She is not on any anticoagulants. The consultant decided to request a blood test on the patient which proved to be abnormal, so the laboratory requested an urgent repeat. Following the repeat specimen, a haematology referral was requested. The results of all three specimens and further investigative tests are shown below, with normal ranges provided.

Your task:

• Give a reasoned interpretation of the patient presentation and data above.
• Suggest a differential diagnosis and any further testing that might be useful to resolve it.
• Summarize the disease biology and comment on the likely prognosis and current treatment.
• Support your answers with relevant academic, peer-reviewed references, cited and listed in proper Harvard style.

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