Why neither workup found the cause

Her bleeding was investigated as a gynecologic problem and her infertility as a separate misfortune. Both investigations were competent, and neither asked what else had been inflaming her peritoneumThe membrane lining the abdominal cavity and organs. for thirty years.

Recurrent peritonitis leaves adhesions, and adhesions distort the structures a pregnancy depends on. Chronic inflammation also disturbs the hormonal axisSecond cervical vertebra; has the odontoid process (dens) for pivoting head (“no” motion). driving the cycle. Two mechanisms, one disease, both invisible to a workup scoped to the pelvis.

Chart Clue #21 — logged

Check everything from Module 21

These activities assess the module as a whole — every part, not just one. Work down from low-stakes self-check to the graded quiz, then consolidate. Each H5P box below is waiting for its shortcode id.

Tier 1 · Self-check — warm up, ungraded

Tier 2 · Graded — the module quiz

Tier 3 · Consolidate — lock in the big ideas

Where this goes next

Module 22 — The Immune System — Capstone. Genetic testing returns two pathogenic MEFV variants and the diagnosis is confirmed. This capstone builds the immune system and then uses it to close the case — every clue in Stina’s chart, traced back to a single defect. Begin Module 22 →