Reference no: EM133805554

Question

Jane, a 29-year-old female laboratory technician, was admitted to the medical service via the emergency room because of blood in her urine. Ms. Jane said that she was being treated for systemic lupus erythematosus (SLE; an autoimmune disease characterized by acute and chronic inflammation of various tissues of the body) by a physician located in a different city. She also mentioned having had von Willebrand's disease (a rare hereditary blood disorder that can cause extended or excessive bleeding) as a child. On the third day of her hospitalization, a medical student mentioned to the resident that she had seen this patient several weeks earlier at a different hospital in the area, where the patient had been admitted for the same problem but had left that hospital suddenly before the workup could be completed. The fact that she neglected to report such a recent prior hospitalization raised suspicions among the hospital staff and prompted a search of the patient's belongings, which revealed a cache of anticoagulant medication. When confronted with this information, she refused to discuss the matter and hurriedly signed out of the hospital against medical advice.