Bloody Red Flags

Author: Maja Szymanska / Editor: Sarah Edwards / Codes: ObC13, ObP2, SLO1 / Published: 05/05/2022

A 60-year-old female patient presents to the Emergency Department (ED) with vaginal bleeding. She reports that she noticed some blood spotting on her underwear on several occasions over the past 3 weeks. She says that the blood is bright read and there is no discharge. She had menarche aged 11, menopause at age of 55 and is currently not sexually active. She had a breast cancer at age of 51 for which she had mastectomy and chemotherapy and has been on Tamoxifen since then.

She is haemodynamically stable and basic observations are within a normal range.

On abdominal examination there are no palpable masses, the abdomen is soft and non-tender. Speculum and bimanual examinations are also normal and no obvious source of bleeding is identified.