Category Archives: Thrombosis

Case 93 – summary

Posted on 18/05/2018 by TeamHaem

This case highlighted a number of issues in the management of VTE. 1) The investigation of a patient with newly diagnosed DVT One of the most useful parts in the history taking is the identification of a provoking factor. We … Continue reading →

Posted in Anticoagulation, Thrombosis | Tagged anticoagulation, cancer, compression hosiery, DVT, IVC filter, recurrent DVT, surgery, thrombosis, VTE | Leave a comment

Case 93 – update 3

Posted on 16/05/2018 by TeamHaem

Our patient has his d-dimer checked which is positive and has an ultrasound scan of the left leg which has confirmed a clot. On review of the images the clot is more extensive that previously. This combined with the clinical … Continue reading →

Posted in Anticoagulation, Thrombosis | Tagged anticoagulation, cancer, DVT, surgery, thrombosis | Leave a comment

Case 93 – update 2

Posted on 15/05/2018 by TeamHaem

We discussed what anticoagulant to start in our patient with a newly diagnosed DVT. There are a number of options and the main ones will include: LMWH then warfarin LWMH then dabigatran Rivaroxaban Apixaban LMWH then edoxaban Various factors … Continue reading →

Posted in Anticoagulation, Thrombosis | Tagged anticoagulation, compression hosiery, DVT, thrombosis | Leave a comment

Case 93 – update 1

Posted on 14/05/2018 by TeamHaem

Our patient has a confirmed proximal DVT and we recognised the important points in the clinical evaluation by looking for provoking factors: Malignancy Family history Periods of immobility Recent surgery or hospital stays Hormonal therapy or pregnancy Nephrotic syndrome Autoimmune … Continue reading →

Posted in Anticoagulation, Thrombosis | Tagged anticoagulation, DVT, thrombosis | Leave a comment

Case 93 – the beginning

Posted on 13/05/2018 by TeamHaem

Welcome to our new #TeamHaem case. You are the acute medicine senior house officer working in ambulatory care. A GP has referred a 58 year old gentleman with left leg swelling and is concerned about deep vein thrombosis (DVT). He … Continue reading →

Posted in Anticoagulation, Thrombosis | Tagged DVT, thrombosis | Leave a comment

Case 87 – summary

Posted on 04/12/2017 by TeamHaem

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 anticoagulation, d-dimer, imaging, Obstetrics, pregnancy, pulmonary embolism, thrombophilia, VTE | Leave a comment

Case 87 – the beginning

Posted on 26/11/2017 by TeamHaem

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 anticoagulation, d-dimer, imaging, Obstetrics, pregnancy, pulmonary embolism, thrombophilia, VTE | Leave a comment

Case 86 – part C2

Posted on 16/11/2017 by TeamHaem

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 FFP, haemolysis, plasma exchange, red cell fragmentation, thrombosis, TTP | Leave a comment

Case 86 – part 3A

Posted on 15/11/2017 by TeamHaem

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 FFP, haemolysis, plasma exchange, red cell fragmentation, thrombosis, TTP | Leave a comment

Case 82 – update 2

Posted on 22/08/2017 by TeamHaem

Our patient continues to deteriorate and the following investigations are now back: Hb 103, Plts 75, WCC 3.4, Neuts 1.6. Blood film: red cell fragments with infrequent spherocytes and polychromasia. Bili 152 (predominantly conjugated), ALT 54, Alk phos 340. Urea … Continue reading →

Posted in Anticoagulation, Thrombosis | Tagged anticoagulation, DOAC, liver failure, Lupus anticoagulant, pulmonary embolism, renal failure, rivaroxaban | Leave a comment

Case 82 – update 1

Posted on 22/08/2017 by TeamHaem

Thanks for all the contributions! We now know from the history and investigations requested that: This patient has had no obvious provoking factors for both his previous and current PE – including no symptoms/signs suggestive of autoimmune disorder / maligancy. … Continue reading →

Posted in Anticoagulation, Thrombosis | Tagged anticoagulation, DOAC, liver failure, Lupus anticoagulant, pulmonary embolism, renal failure, rivaroxaban | Leave a comment

Case 82 – the beginning

Posted on 20/08/2017 by TeamHaem

Welcome to our new case! A 45 year old gentleman is admitted to the medical assessment unit as he has been diagnosed with a large pulmonary embolus (PE) within the right pulmonary artery. He is requiring 2 litres of oxygen … Continue reading →

Posted in Anticoagulation, Thrombosis | Tagged anticoagulation, DOAC, pulmonary embolism, rivaroxaban | Leave a comment

Case 66 – summary

Posted on 22/10/2016 by TeamHaem

Thanks for all who have been involved in this week’s case. We reviewed the causes of thrombocytosis in general and also applicable to pregnancy. Causes of thrombocytosis are usually reactive or secondary to another cause: Blood loss Infection/inflammation Malignancy Thrombopoietin … Continue reading →

Posted in Myeloproliferative neoplasm, Related to other specialities, Thrombosis | Tagged DVT, essential thrombocytosis, iron deficiency, JAK2, LMWH, myeloproliferative, pregnancy, Thrombocytosis, thrombosis, venous thromboembolism | Leave a comment

Case 66 – update 3

Posted on 19/10/2016 by TeamHaem

Our patient is diagnosed with essential thrombocythaemia/thrombocytosis (JAK2 V617F positive) and is started on aspirin 75mg od. At 28 weeks she has a painful swollen left leg. It is hot and tender. An ultrasound confirms a deep vein thrombosis. … Continue reading →

Case 66 – update 2

Posted on 18/10/2016 by TeamHaem

All reactive causes of thrombocytosis have been ruled out and our pregnant patient has a persistently elevated platelet count of 500×10*9/L. There is no history of VTE or miscarriage. There are no systemic symptoms such as weight loss, rash or … Continue reading →

Posted in Myeloproliferative neoplasm, Related to other specialities, Thrombosis | Tagged essential thrombocytosis, iron deficiency, JAK2, myeloproliferative, pregnancy, Thrombocytosis | Leave a comment

Case 58 – summary

Posted on 30/05/2016 by TeamHaem

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 →

Posted in Anticoagulation, Thrombosis | Tagged anticoagulation, coagulation, d-dimer, DVT, Swollen leg, ultrasound, VTE, wells score | Leave a comment