Case 1

Give 5 possible diagnoses.

You take a full history. Which of the following might point towards a non-organic cause? (Select all that apply)

Mum reveals that she thinks the pains are due to painful periods.

Give 4 features on the examination that might indicate precocious puberty.

Her examination reveals that she is pre-pubertal. Previous blood tests confirm this. You are concerned about FII as the reported symptoms do not match the physical findings and investigations. However you must consider other potential diagnoses.

Which of the following are differentials for vaginal bleeding? (Select all that apply)

Given your concerns regarding FII, list 3 actions you should take.