Category Archives: Anticoagulation

Case 81 – summary

Thank you for all the contributions to the case this week. The case We looked at a case of a 58 year gentleman who had an incidental finding of thrombocytopenia, whilst on apixaban therapy. Immediate intervention was required to stop … Continue reading

Posted in Anticoagulation, Acquired bleeding, Platelet disorders | Tagged , , ,

Case 81 – update 2

Thankfully the bleeding resolves and no surgical intervention is required The platelet count responds to IVIG, and dexamethasone 40mg given for four days. Any further investigations required?   2 week s following commencement of steroids the platelet count has fallen … Continue reading

Posted in Acquired bleeding, Anticoagulation, Platelet disorders | Tagged , , ,

Case 81 – update 1

Our followers have come up with a very comprehensive list of investigations! Our advice/investigation included stopping apixaban Checking Fbc ? Any other abnormalities/previous FBC/ clot in sample  coagulation.  Prolonged PT, normal aptt and fibrinogen renal and liver function HIV, hepatitis … Continue reading

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Case 81 – the beginning

A 58 year old gentlemen has routine bloods taken at the GP surgery.  He is noted to have a platelet count of 38. His doctor rings you as the haematology registrar for advise as he is on apixaban for treatment … Continue reading

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Case 74 – summary

Thankyou for your input this week!This week we had a look at a few abnormalities that can be seen on coagulation screens in a pre procedure setting. The first thing to say is there is no replacement for a good … Continue reading

Posted in Acquired bleeding, Anticoagulation, Inherited bleeding | Tagged , , , , , , ,

Case 74 – part 3

We have our 3rd and final case of the week! A 40 year old man who has a vasculitis ,who has been requiring plasma exchange, needs to have a new line put in for exchange. The renal team are concerned … Continue reading

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Case 70 – part 3 – summary

For our last short case this week we looked at a 50 year old gentleman who developed a subdural following an assault. He had been diagnosed with a provoked DVT 1 week prior following knee surgury and had been loaded … Continue reading

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Case 70 – part 3 – the beginning

And for our last case, a 50 year old gentleman has attended A&E following an assault. A CT head has shown a subdural and the neurosurgeons want to take him to theatre. The patient had a knee replacement about 4 … Continue reading

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Case 70 – part 2 – summary

We have a 76 year old gentleman with AF and a recent CVA making him high risk for thromboembolic events.  He was on dabigatran and presented 5 hours after taking his last dose with haematemesis and a perforated DU.  Dabigatran … Continue reading

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Case 70 – part 2 – the beginning

So we now have our second case. A 76 year old gentleman had been admitted under the surgeons with a haematemesis and a perforated duodenal ulcer. The surgeons would like to take him to theatre within the next hour. The … Continue reading

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Case 70 – part 1 – summary

So our patient was a 75 year old male who has a PMH of NIDDM, HTN, AF and a previous bioprosthetic AV replacement. He is anticoagulated for AF with a CHADS2 score of 3 – which is an annual stroke … Continue reading

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Case 70 – part 1 – the beginning

Welcome to our cases this week. This week we will do 3 short cases looking at anticoagulation and perioperative management around elective and emergency surgery. Our first case is a patient who is being seen pre operatively. The patient needs … Continue reading

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Case 58 – summary

We covered a lot of issues this week. Here is a link to the case on Storify: https://storify.com/TeamHaem/case-58-teamhaem-does-dvt Our patient was a 37 year old female with left leg swelling. She had no major medical problems and was on no … Continue reading

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Case 58 – update 4

Our patient has a confirmed left sided DVT. Prior to initiation of anticoagulation a clotting screen is performed. It shows: PT 12s (11-14) APTT 49s (35-40) Fibrinogen 5.5g/L (1.5-4) d-dimer 990ng/mL (<500)   Questions How do you interpret the results? … Continue reading

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Case 58 – update 3

Our patient has a swollen left leg and an intermediate Wells’ score but a positive d-dimer result. She goes on to have an ultrasound of her lower limb. There is debate on whether to do a full leg ultrasound scan … Continue reading

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Case 58- update 2

Our patient has a possible DVT. She has a painful, swollen left leg with some mild erythema. The Wells’ score is 1 and therefore a d-dimer test is required. Had the score been 2 it would be reasonable to move to … Continue reading

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Case 58 – update 1

Thanks for the contributions so far.   We have established that our patient is a 37 year old female and has presented to her general practitioner with a swollen left leg. She had a recent car journey of 90 minutes … Continue reading

Posted in Anticoagulation, Thrombosis | Tagged , , , , ,

Case 58 – the beginning

Welcome back to TeamHaem. Please read the case below then make some comments/answer the questions on Twitter using #TeamHaem.   A 37 year old female presents to her general practitioner with a swollen leg which has gotten worse over the … Continue reading

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Case 39 – summary

.The final part of our case was dedicated to discussing what tests, if any, should be requested on a patient presenting with an unprovoked VTE (uVTE). Clearly there are many other topics in the field of ‘clots and cancer’ that … Continue reading

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Case 39 – update 2

In the last few days we have established that the 74 year old man with a confirmed DEEP vein thrombosis (in the superficial femoral vein – see this link for discussion of this misnomer: http://jama.jamanetwork.com/article.aspx?articleid=389874). He has had significant indigestion … Continue reading

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