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Author Archives: TeamHaem
Case 103 – update 1
We have found out that our patient has just started adjuvant chemotherapy for breast cancer following surgery. Five days prior to admission she had a 2 unit blood transfusion, which had no immediate complications. She had no transfusions prior to … Continue reading
Posted in Uncategorised
Case 103 – the beginning
Welcome to this week’s teamhaem case! This week we start with a 50 year old lady who has presented to A&E complaining of feeling tired and she has, over the previous couple of days, noticed blood in her urine, however … Continue reading
Posted in Uncategorised
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
Posted in Uncategorised
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
Posted in Uncategorised
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
Posted in Uncategorised
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
Posted in Uncategorised
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
Posted in Uncategorised
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
Posted in Uncategorised
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
Posted in Uncategorised
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
Posted in Uncategorised
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
Posted in Uncategorised
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
Posted in Uncategorised
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
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
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 bleeding, bleeding history, epistaxis, thrombocytopenia
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 Lymphocytosis, mantle cell lymphoma
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 Blood film, Flow cytometry, Lymphocytosis, mantle cell lymphoma, morphology
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 Lymphocytosis
