9th June 2025

A 24-year-old woman is seen on the Medical Admissions Unit after vomiting for the last week.

A 24-year-old woman is seen on the Medical Admissions Unit after vomiting for the last week. She is usually physically well, but has acne and depression. Her GP has prescribed sertraline. She has been taking isotretinoin, which she has obtained over the internet. She says that she has nausea and that she has felt much lower in mood over the last few days than usual, although she has no thoughts of self-harm. Her Hospital Anxiety and Depression Score indicates moderate depression. 

Blood tests:

Hb 112 g/L (115-150)

WCC 3.3 x 109/L (3.8-10)

Neutrophils 0.8 x109/L (2.0-7.5)

Urea & electrolytes normal

ALT 90 IU/L (10-50)

β-hCG 15500 mIU/mL

Referral to which specialty is most important?

Select the SINGLE most appropriate option from the list below. Select ONE option only.