You are called to see a 12 year old female who presents to the emergency room after nearly fainting in the bathroom. She was rushed to the emergency room by the housekeeper who was watching her after school. She is alert when you speak to her in the emergency room. Today after school, she states that she was in the bathroom at home when she suddenly felt nauseous and dizzy and fell to her knees. The noise of the fall prompted her caretaker to come to the bathroom and she saw the patient sitting on the floor with minimal consciousness. The patient was brought to the hospital immediately. She reports intermittent crampy abdominal pain. The patient denies nausea, vomiting at this time. She has a good appetite. She denies urinary symptoms. She reports a normal bowel movement this morning. You learn that 6 days ago her first menses began. The first 2 days consisted of light spotting. For the last 4 days, however, the menses has been quite heavy and she had to change a pad every 45 minutes as they have been soaked. The patient states that since her period started she has been increasingly tired and dizzy at times when she stood up too fast. The patient also notices that she bruises easily. She has had one nosebleed in her life in 2nd grade.