MRCP2-3785

A 35-year-old female presents to the Emergency department with sharp, stabbing abdominal pain that has been present for several days. She reports feeling nauseated but has not vomited and has not noticed any changes in bowel or urinary habits. Her periods are irregular but not heavy, and her last period was two weeks ago. She had previously attended another hospital where she underwent various investigations, including an ultrasound of the abdomen, which all came back normal. However, she believed that the staff were incompetent and that something was amiss, resulting in her being escorted out of the hospital by security due to aggressive outbursts. On examination, she appeared cooperative and animated, with multiple recent scars across her abdomen and left arm. She occasionally takes cocaine and drinks 20 units of alcohol per week, and she lives with her boyfriend and is unemployed. Her vital signs are normal, and her tests show a haemoglobin level of 155 g/L, mean cell volume of 95 fL, white cell count of 6.1 ×109/L, platelets of 202 ×109/L, serum sodium of 139 mmol/L, serum potassium of 4.2 mmol/L, serum urea of 4.9 mmol/L, and serum creatinine of 78 µmol/L. What does this patient exhibit?