Possible miscarriage and pregnancy?

Patient : I did not get my period for almost three months. I was nauseous, tired and moody. A month ago when I got my period it came with extreme lower abdominal pain, a lot of what I thought was menstrual blood and there was a large looking blood clot of a tissue-like substance in the toilet. Is it possible I was actually pregnant and suffered a miscarriage without realizing it?
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