Author Archives: TeamHaem

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Online education and discussion about all things haematological

Case 102 – The Summary

  Thank you for all the contributions to the case this week! This week we discussed a 29 year old lady who presented with an extensive left arm DVT. She had been on the COCP for 2 years. Further investigations … Continue reading

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Case 102 – Update 3.

We now have further results for our 29 year old female who presented with an extensive left arm DVT and SOB. She was commenced on therapeutic LMWH. This thrombosis was provoked as she has been found to have a 11cm … Continue reading

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Case 102 – Update 2.

Thanks for everyone’s contributions! We have been discussing the management of a predominantly idiopathic upper limb DVT in our young lady on the combined OCP. She is on therapeutic LMWH and currently continues on the combined OCP. However, your requested … Continue reading

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Case 102 – Update 1.

Thanks for everyones contributions! Following everyone’s suggestions we now know that this 29 year old with an extensive upper limb DVT, has been short of breath over the past few weeks and non-specifically unwell. She has been on the combined … Continue reading

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Case 102 – The Beginning

Welcome to the new #TeamHaem Case! You are working in the acute medical day unit. A 29 year old female has been referred in with a week long history of progressive left arm swelling. An ultrasound has confirmed an extensive … Continue reading

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Case 101 – summary

This is a case of super warfarin overdose. It was complicated by the lack of accurate history from the patient due to presentation with an intra cranial haemorrhage. Super warfarin are easily available as rodenticides. The most common in the … Continue reading

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Case 101 – update 3

Further history is sort and her partner confirms the presence of rat poison in the house. Repeat factor levels show: Factor II – 24%                         Factor VII – 9% Factor … Continue reading

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Case 101 – update 2

She is treated for vitamin K deficiency and prescribed 10mg vitamin K IV for a further 2 days. 36 hours after admission you are called because she had developed epistaxis and frank haematuria. Repeat bloods show: Hb 89  g/l MCV … Continue reading

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Case 101 – update 1

She is given prothrombin complex concentrate and vitamin K 10mg IV. She has a history of asthma and depression, she has taken sertraline for the last five weeks and salbutamol inhalers infrequently.  There is no history of anticoagulant use and … Continue reading

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Case 101 – the beginning

Welcome to the new #TeamHaem Case! You are a medical doctor working in a busy emergency department. You are called to review a 34 year old woman who has been brought in by ambulance.  She was found by her partner … Continue reading

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Case 100 (part D) – summary

The patient had mild thrombocytopenia and has suffered epistaxis. Epistaxis is relatively common and therefore structural causes should also be looked into. This is especially so if the nose bleeds are unilateral. There is a wide differential of why someone … Continue reading

Posted in Inherited bleeding, Laboratory morphology, Paediatric haematology, Platelet disorders | Tagged , , , , , , , ,

Case 100 (part D) – update

You repeat the FBC and it shows similar results Hb 141g/l (130-180) MCV 89fl (82-98) WCC 7.5×109/l (4-11) Neutrophils 4.7×109/l (1.7-7.5) Lymphocytes 2.1×109/l  (1.5-4.5) Platelets 70×109/l (150-450) Coagulation screen – normal U&E/LFT – normal Blood film: Questions What is the … Continue reading

Posted in Inherited bleeding, Laboratory morphology, Paediatric haematology, Platelet disorders | Tagged , , , , , ,

Case 100 (part D) – the beginning

You are a GP evaluating a 12 year old boy with persistent nose bleeds. He otherwise feels well with no past medical history. He is on no medications. FBC shows: Hb 140g/l (130-180) MCV 90fl (82-98) WCC 8.5×109/l (4-11) Neutrophils … Continue reading

Posted in Inherited bleeding, Paediatric haematology, Platelet disorders | Tagged , , ,

Case 100 (part C) – summary

Our patient had a mild lymphocytosis. The differentials include: Reactive – especially viral illnesses Hyposplenism Smoking Polyclonal B cell lymphocytosis – binucleate lymphocytes with isochrome 3q Lymphoproliferative neoplasms such as CLL and other types of lymphoma In the first instance … Continue reading

Posted in Chronic leukaemia, Laboratory morphology, Lymphoma | Tagged ,

Case 100 (part C) – update 1

Our patient has a mildly elevated lymphocyte count and this is persistent on repeat. In the absence of reactive causes the most likely explanation is a low grade lymphoproliferative neoplasm such as CLL. After a period of monitoring the patient’s … Continue reading

Posted in Chronic leukaemia, Laboratory morphology, Lymphoma | Tagged , , , ,

Case 100 (part C) – the beginning

You are in a GP surgery and are asked to perform a full blood count on a 60 year old male who is awaiting a knee replacement for osteoarthritis. He has a past history of glaucoma, hypertension and a myocardial … Continue reading

Posted in Chronic leukaemia, Lymphoma | Tagged

Case 100 (part B) – summary

Our patient had a mild neutrophilia. Neutrophilia can be seen in: Neonates Infection Especially bacterial (note marrow depletion may occur leading to neutropenia) Inflammation, autoimmune diseases etc. Acute gout Stressed states with high adrenaline e.g. myocardial infarction, exercise, acidosis, eclampsia, … Continue reading

Posted in Laboratory morphology, Myeloproliferative neoplasm, Related to other specialities | Tagged , , , , , , ,

Case 100 (part B) – update

Our patient’s neutrophilia/thrombocytosis is attributed to his chest infection. You advise to get a repeat FBC in one month but he forgets and goes to Spain for some ‘winter sun’. On return he has a repeat FBC: Hb 145g/l (115-165) … Continue reading

Posted in Laboratory morphology, Myeloproliferative neoplasm, Related to other specialities | Tagged , , , , ,

Case 100 (part B) – the beginning

You are at a GP surgery and you see a 59 year old gentleman. He has a past history of colorectal cancer than was operated on two years ago and he never needed chemotherapy. He has hypertension and benign prostatic … Continue reading

Posted in Myeloproliferative neoplasm, Related to other specialities | Tagged , ,

Case 100 (part A) – summary

Our patient had mild neutropenia. Neutropenia has a number of causes and the finidning of neutriopenia should prompt clinical evaluation.   Causes of neutropenia include Sepsis secondary to exhausting neutrophil pool Nutritional deficiency – B12, folate, copper, anorexia Hypersplenism Viral … Continue reading

Posted in Bone marrow failure, Related to other specialities | Tagged ,