Author Archives: TeamHaem

About TeamHaem

Online education and discussion about all things haematological

Case 87 – summary

This week we looked at a case of pulmonary embolism in a lady who was 28 weeks pregnant.   Initial management included: ABC ECG – T wave inversion. S1Q3T3 pattern and right bundle branch block.  May also help with identifying … Continue reading

Posted in Anticoagulation, Related to other specialities, Thrombosis | Tagged , , , , , , ,

Case 87 – the beginning

A 32 year old lady presents to A&E with incresing shortness of breath and chest pain.  She is 28 weeks pregnant. What further information do you need? Initial management/investigations?

Posted in Anticoagulation, Related to other specialities, Thrombosis | Tagged , , , , , , ,

Case 86 – part C2

Thanks for your help with this short case. We examined this blood film of an unwell female: The most striking abnormality is red cell fragmentation. This can be seen in: AIHA/Evans’ syndrome DIC Pregnancy-associated (HELLP, pre-eclampsia, malignant hypertension, fatty liver of … Continue reading

Posted in Laboratory morphology, Platelet disorders, Thrombosis, Transfusion | Tagged , , , , ,

Case 86 – part 3A

A 32 year old female presents with headaches, visual disturbance and fever. Hb 92g/L MCV 99fl Platelets 38×109/l WCC and differential – mild neutrophilia Questions Name some features of the blood film? What are the differential diagnosis? What further investigations … Continue reading

Posted in Laboratory morphology, Thrombosis, Transfusion | Tagged , , , , ,

Case 86 – part B2

Thanks for joining in with this short case. We reviewed the blood film of an 82 year old. The FBC was done for diabetes monitoring. There was no recent transfusion and no new medications. The film showed red cell agglutination(3) … Continue reading

Posted in Anaemia, Laboratory morphology, Lymphoma | Tagged , , , ,

Case 86 – part B1

An 82 year old gentleman has a routine blood count for diabetes monitoring. This is the blood film.   Questions: What do you see on the blood film? What questions do you want to ask the patient? Any further investigations? … Continue reading

Posted in Anaemia, Laboratory morphology, Lymphoma | Tagged , , , ,

Case 86 – part A2

This short case focused on the diagnosis of thalassaemia over iron deficiency. The below factors can help, but there are many overlapping factors and this is more of a guide rather than absolute. Factors that may make this unreliable include … Continue reading

Posted in Anaemia, Haemoglobinopathy, Laboratory morphology | Tagged , , , , , , ,

Case 86 – part A1

Welcome to #TeamHaem. This week we are going to look at some blood film morphology. A 21 year old female student has a full blood count done due to fatigue. Hb 100g/L MCV 74fl MCH 21.7pg Platelets 250×109/l WCC and … Continue reading

Posted in Anaemia, Haemoglobinopathy, Laboratory morphology | Tagged , , , , , , ,

Case 85 – summary

So, our patient has had quite a week! Thanks to your efforts, he is safely back on the ward, conscious and improving.  Recap: We have managed an emergency presentation of an unconscious patient with severe hypercalcaemia, hyperviscosity and an AKI. … Continue reading

Posted in Myeloma/paraproteins | Tagged , , , , ,

Case 85 – update 2

We rejoin our patient on HDU… He remains unconscious and lacks capacity to currrently make decisions regarding his further management.  Based on our team’s suspicion of an underlying plasma cell disorder, that may be driving our patient’s hypercalcaemia, AKI and … Continue reading

Posted in Myeloma/paraproteins | Tagged , , , , ,

Case 85 – update 1

Thank you for all your help so far on the medical admissions unit. Assessment Our patient was initially assessed using an ABCDE approach: A) Snoring, requiring an airway adjunct (nasopharangeal airway) B) RR16, chest clear to auscultation, sats 97% room … Continue reading

Posted in Myeloma/paraproteins | Tagged , , ,

Case 85 – the beginning

Welcome to our new case. We need your help urgently. Our patient is a 55 year old man who is drowsy and confused. His friend is extremely worried and has brought him to the Medical Admissions Unit front door for … Continue reading

Posted in Myeloma/paraproteins | Tagged

Case 84 – summary

Thank you for all your help with this weeks case! This week we looked at a case of a patient with type 1 Gaucher’s disease . She was found to be mildly anaemia with a mild thrombocytopenia. A CT scan … Continue reading

Posted in Acquired bleeding, Bone marrow failure, Laboratory morphology, Related to other specialities | Tagged , , , , ,

Case 84 – update 2

So we have the results of our patient’s bone marrow and it looks to be consistent with Gaucher’s disease! Our patient has a raised serum ACE and ferritin which is typical of Gaucher’s disease. Our bone marrow shows the typical … Continue reading

Posted in Acquired bleeding, Bone marrow failure, Laboratory morphology, Related to other specialities | Tagged , , , , ,

Case 84 – update 1

So we have an update: We have found our patient is thrombocytopenic, and has a mild normocytic anaemia. Our patient has been slightly tired for a year or so, but still manages to do her demanding job as a PE … Continue reading

Posted in Acquired bleeding, Bone marrow failure, Laboratory morphology, Related to other specialities | Tagged , ,

Case 84 – the beginning

Welcome to our new case! We start in the GP surgery with a 21 year old woman. She has been feeling tired for a while so has come to get checked. Your colleague did some bloods on the previous visit … Continue reading

Posted in Acquired bleeding, Bone marrow failure, Laboratory morphology, Related to other specialities | Tagged

Case 83 – summary

Many thanks to everyone who contributed to our case. This week the case centred on a pregnant female who was an obligate carrier of Haemophillia A (Her Father was affected). She had a factor VIII level of 54%. She was … Continue reading

Posted in Inherited bleeding, Paediatric haematology, Related to other specialities | Tagged , , , , , , ,

Case 83 – update 3 

Our pregnant patient had a factor VIII level of 54%. She is a carrier of intron 22 inversion as predicted from family history.  The free fetal DNA testing confirms she is carrying a male fetus. The patient has decided that … Continue reading

Posted in Inherited bleeding, Paediatric haematology, Related to other specialities | Tagged , , , , , , ,

Case 83 – update 2

Our pregnant patient returns to clinic she is now 13 weeks pregnant.  Her factor VIII level was 54%. She is a carrier of intron 22 inversion as predicted from family history.  The free fetal DNA testing confirms she is carrying … Continue reading

Posted in Inherited bleeding, Related to other specialities | Tagged , , , , , ,

Case 83 – update 1

After consideration of her family tree you realise  if there are no non-paternity issues she is an “obligate carrier” of Haemophillia A.  After counselling and discussion she agrees to having genetic testing for herself. She is willing to have free … Continue reading

Posted in Inherited bleeding, Related to other specialities | Tagged , , , , ,