AKT-1611

AKT-1611

A middle-aged woman of Chinese origin presents to you in surgery to discuss her recurrent nosebleeds. They started 3 months ago and have been occurring unprovoked with increasing frequency. She is not on any anticoagulants, has never had any previous episodes of unexplained or excessive bleeding, and has no family history of any bleeding disorders. On further questioning, the nosebleeds always seem to be from the right nostril which feels a bit blocked. She has tried 2 weeks of Naseptin (chlorhexidine dihydrochloride and neomycin sulfate nasal cream) with no change in her symptoms. She mentions that the previous GP she saw asked about weight loss which she denied at the time, however, she volunteers that she has been tightening her belt more now. Blood tests reveal normal coagulation screen, haemoglobin within the normal range and a thrombocytosis. What condition is it most important to investigate for?