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Margery's maternal grandparents moved to Cincinnati, Ohio, from Ireland before her mother was born. Both her paternal grandparents were of Scottish ancestry. Margery recently married Sam, and they want to put off having children until they are financially stable. She is interested in advice about birth control and asks for information about oral contraceptives during her routine physical examination. You take a family history and find out that Margery's mother has a history of blood clots, and her paternal grandfather died from a stroke.
1. Why is the history of blood clots and stroke important to consider in Margery's decision regarding oral contraceptives?
2. How is Margery's Celtic background relevant to her risk of blood clots?
3. Should you suggest that she have genetic testing for factor V Leiden?
4. How could your concerns be handled in a professional manner consistent with your scope of practice?
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