A&E department

An ambulance has just brought Katie, a 17-year-old girl suffering from repeated fainting spells, to A&E. Katie is not in a communicative mood during your examination, her answers are short and reluctant, her most recent fainting has not taken her by surprise. She insists that everything is fine and that she was only tired. She also says that she is used to occasional fainting, reassuring you that everything will be okay and asking you to let her go home. She explains her malnutrition by loss of appetite and by stomach ache. According to her, everything is related to increased stress due to this year’s school-leaving exam.

Image courtesy: David Castillo Dominici (FreeDigitalPhotos.net)

Due to her current condition, however, she has not enough energy to leave and submits to necessary clinical examination. She is rather passive, not providing any more information which would explain her current physical symptoms.

Shortly afterwards, Katie’s mother also arrives to A&E. The mother knows about her daughter’s problems and says that she would like to help her but that Katie does not listen to her. The mother also explains that her daughter has been losing weight for some time; Katie, however, denies it.

Which basic clinical examinations would you perform? Answers:

Examine the results of the initial examination.