long-standing asthma

Case study scenario:
Adina, a 43-year-old woman comes in for her first visit at your clinic. She is a Kunjen woman from Kowanyam, in far north Queensland. Her past medical history is notable for long-standing asthma. She takes budesonide (inhalation) most days and prednisolone (orally) for severe exacerbations; this has been the case for much of her adult life. She is married with six children; her husband is an interstate truck driver. Her first sexual contact was at age 14, and she has had six sexual partners in her lifetime, but took the pill to prevent pregnancy. She has been smoking one pack of cigarettes per day for the last 30 years. She reports vaginal bleeding, particularly after intercourse which has become painful; she thinks is related to vaginal dryness after menopause. Adina, also reports of fatigue, weight loss and pelvic pain over the past 2-3 months.

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