Author Archives: TeamHaem

Our case presented a 34 year old lady with known sickle cell disease to the A&E department complaining of shortness of breath and chest pain.  The case starts by reminding us of the basic management of a patient with sickle … Continue reading →

Imaging has confirmed a pulmonary embolism.  How would you manage this patient?  What would be our long term management?   She has been expressing the desire to become pregnant, what you be your advise?

Baseline observations – sats 89% room air, HR 126, BP 111/65, RR33, temp 36.5 Chest x-ray – NAD D-dimer – 775 ( normal range 208-318 ng/ml) Hb 67 g/L Retics – 4% HbS 40% eGFR 70 ml/min Urinalysis 1+ protein … Continue reading →

Welcome to our next case.   A 34 year old female presents to A&E with increased shortness of breath and chest pain. You are contacted as the haematology registrar oncall, by the SHO working in A&E as the patient has … Continue reading →

So thanks for all of your input into our 2 short cases which focused on transfusion in cases of anaemia and some of the complications which you may get asked about. Most important points to make are that blood transfusion … Continue reading →

He is 2 weeks into his first cycle of intensive chemotherapy. You have been asked to review him by the nursing staff as he has a unit of red cells running but his temperature is now 38.9 degrees and he … Continue reading →

A 34 yr old gentleman is an inpatient on the haematology ward. This is his film 2 weeks ago at diagnosis. Anyone want to comment?    

It is nearly midnight and the patient wakes from sleep feeling breathless and scared. The nurses ask you to come and assess the patient. His RR is 32, sats are 91% on RA, BP is 145/89 and HR is 134. … Continue reading →

Thanks for all your comments on the blood film – you mentioned  hypersegmented neutrophils, tear drop cells as well as a macrocytic anaemia, possible ovalocytes and some rouleaux.  You add a B12 and folate level as well as immunoglobulins onto … Continue reading →

Thanks for all your requests for more information! The gentleman regained consciousness before the ambulance crew arrived and is now GCS 14 – he remains confused and is unsure of how he came to be in hospital.  He says he … Continue reading →

This week we will run a few short basic cases which you might come across in general medicine. Case 1)  A 72 yr old man is admitted to A&E with a collapse. He has a macrocytic anaemia with Hb 36g/L. … Continue reading →

Thanks for all your help this week. This week’s case focused on Thrombocytopenia pregnancy that ultimately was ITP responsive to steroid therapy. Mild gestational thrombocytopenia (with platelet counts <150×10^9/L) is common affecting up 5-10% of pregnant women. Pregnant women with … Continue reading →

Thanks for your help so far. The lady thankfully had an uneventful normal vaginal delivery. She had chance to have an anaesthetics review prior to labour and had been attending joint obstetric and haematology clinic. Her pre prepared birth plan … Continue reading →

The lady’s platelet count responded to 20mg Prednisolone and is now at 65×10^9 at 38 weeks gestation.  The obstetric team are keen for a plan for delivery what advice would you give the team?  What advice would you give to the … Continue reading →

You suspected ITP or possibly gestational thrombocytopenia and embarked on monitoring her platelet counts every few weeks. The lady is now 34 weeks pregnant and is otherwise well. Her platelet count has started to fall over the past 6 weeks and is now … Continue reading →