Diverted by a patient's anxiety and BMI, a GP misses a more serious condition

SMART PRACTICE

Dr Craig Lilienthal describes the case of a GP who missed a diagnosis.

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Background

A 48-year-old woman presented to her GP with menopausal symptoms. After appropriate hormonal investigations, he recommended treatment with HRT, noting her only risk factor was a BMI of 33. 

He discussed the risks, benefits and potential complications of the therapy with her, advised her to lose weight and prescribed a standard oestrogen/progesterone preparation. This was recorded in his

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