ABSTRACT
History A 56-year-old teacher presented to his GP with increasing tiredness and lethargy, which had come on progressively over the preceding 4-6 months. He had been experiencing early satiety recently and feels that this may explain his recent weight loss. He denies any change in bowel habit or obvious blood loss, but does report easy bruising on minimal trauma. Apart from this, he has recently experienced recurrent chest infections that took three courses of antibiotics to clear. On systems review, he reports hearing a whooshing noise in his ears most evenings.
