Category Archives: Thrombosis

Case 82 – update 2

Posted on 22/08/2017 by

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 →

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Case 82 – update 1

Posted on 22/08/2017 by

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 →

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Case 82 – the beginning

Posted on 20/08/2017 by

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 →

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Case 70 – part 3 – summary

Posted on 13/01/2017 by

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

Posted on 12/01/2017 by

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 66 – summary

Posted on 22/10/2016 by

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 →

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Case 66 – update 3

Posted on 19/10/2016 by

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 →

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Case 66 – update 2

Posted on 18/10/2016 by

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 →

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Case 66 – update 1

Posted on 17/10/2016 by

Our pregnant patient with thrombocytosis has ferritin checked which is low at 17ug/l. Her CRP was also checked and it was <5ug/l. She is prescribed oral iron replacement – ferrous sulphate 300mg TDS and a FBC post iron replacement shows: … Continue reading →

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Case 66 – the beginning

Posted on 16/10/2016 by

You are a GP and are reviewing blood tests that were taken during a booking appointment for a 29 year old who is 10 weeks into her first pregnancy. They show: Hb 100g/L (105-165) MCV 76fL (82-98fL) WCC 10×10*9/L (4-11) Neutrophils … Continue reading →

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Case 58 – summary

Posted on 30/05/2016 by

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

Posted on 27/05/2016 by

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

Posted on 25/05/2016 by

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

Posted on 24/05/2016 by

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

Posted on 23/05/2016 by

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 →

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Case 58 – the beginning

Posted on 22/05/2016 by

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

Posted on 18/06/2015 by

.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

Posted on 13/06/2015 by

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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Case 39 – update 1

Posted on 08/06/2015 by

One of the team has written a fantastic summary of differentials and points to consider in the history and examination: thanks olitodd1984! Please see his comments below: Rule out infection– in the history ask about fevers, sweats, rigors, loss of appetite. On … Continue reading →

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Case 39 – the beginning

Posted on 07/06/2015 by

Welcome to case 39, a short case exploring DVT/PE management. Sound dull? Well, we’re going to show you why it’s not just a DVT. This case is particularly aimed at: General medics Surgeons Medical students Nursing students Acute medicine practitioners … Continue reading →

Posted in Anticoagulation, Related to other specialities, Thrombosis | Tagged , , , , | 2 Comments