Advice centre

Mrs Y, a 39-year-old chef, opted to M see consultant obstetrician Mr B for private antenatal care. It was her first pregnancy and other than a BMI of 30 she had no pre-existing medical problems.

Mr P, a right-handed project manager, developed a stiff right elbow following a previous injury, and had reached the limit of his progress with physiotherapy. X-rays showed degenerative changes and he was referred to an orthopaedic consultant, Mr A, who diagnosed osteoarthritis of his elbow.

Mr K was a 36-year-old man who ran a pub. Mr K smoked and drank heavily. Mr K’s dentist had noticed a painless swelling on the right side of his neck during a routine check-up and asked him to see his GP.

Mrs B was a 27-year-old secretary with a ten-year-old daughter. She had just enjoyed a trip to Pakistan where she had been visiting relations. Three days after her return she developed profuse, watery diarrhoea.

Miss F, an 18-year-old university student, had been taking the combined oral contraceptive pill microgynon for 18 months for dysmenorrhoea, when she presented to her GP Dr K worried about acne on her back.

Mr G was a 62-year-old office worker; he was overweight (BMI 29) and suffered from exercise-related angina. Mr G had several risk factors for ischaemic heart disease including smoking, diabetes mellitus and hypercholesterolaemia. Following a positive exercise test, a coronary angiography confirmed triple vessel coronary artery disease with a left ventricular ejection fraction of 45%. He was referred to Mr F, a consultant cardiothoracic surgeon, for consideration of coronary artery bypass graft (CABG) surgery.