Blog Archives

Case 141: Mini case 4

You are the urology FY2, and you have been asked to clerk a patient who has been electively admitted for transurethral resection of bladder tumour (TURBT) in the morning. You look through his pre-assessment bloods from 2 weeks ago and … Continue reading

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Case 141: mini case 3

A 41 year old female patient is an inpatient on the haematology ward progressing through her first cycle of the UKALL14 protocol for a new diagnosis of ALL. She complains of a swollen and painful left arm, and US confirms … Continue reading

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Case 141: Mini case 2

You are the IMT2 doctor on a gastroenterology ward. A 54 year old man has been admitted with decompensated alcoholic liver disease and has fevers with high CRP. As part of the ward round plan you have been asked to … Continue reading

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Case 141: Short case 1

You are an interventional radiology trainee (ST5) and are running a procedure list tomorrow morning, with support from a consultant. You look through the cases and one of the request forms states: ‘New AML. For CPX. Requires Hickman line for … Continue reading

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Case 136 – the summary

This week we followed the case of a 71 year old patient with multiple co-morbidities who required optimisation of her haemoglobin level before an elective operation. The crux of this case is Patient Blood Management, which is something we all … Continue reading

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Case 136 – update 2

We are trying to optimise a 71 year old lady for orthopaedic surgery. You voted in the poll to proceed with IV iron – this has been administered at the correct weight-based dose for her Hb. Repeat bloods 6 weeks … Continue reading

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Case 136 – update 1

We are advising the orthopaedic SpR, Ms Fi Moor, about a 71 year old lady listed for urgent THR who has a normocytic anaemia (Hb 84) and requires optimisation pre-op. You have requested the following info: PMH: Hypertension, type 2 … Continue reading

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Case 136 – the beginning

You are the haematology SpR holding the on-call phone. You are called by an orthopaedic SpR regarding a 71-year-old lady she has reviewed in clinic with significant osteoarthritis of the right hip. The patient’s mobility and quality of life have … Continue reading

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Case 131 – the beginning

It is 9 am and you’re the liaison haematology registrar. Having just finished your coffee, the A+E registrar calls you for some advice about a 42-year-old male with an abnormal full blood count (see below) who presented with shortness of … Continue reading

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Case 130 – Update 1

Thanks for all the input thus far. We are dealing with a panreactive antibody screen (see below) in a patient not previously known to our hospital trust. The sample has been sent to NHSBT red cell immunohaematology (RCI). We are … Continue reading

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Case 130 – the beginning

It is 5pm. You are the haematology SpR and you have just congratulated yourself on clearing the blood films and aspirates to report – good job! But just as you are taking off your lab coat, a transfusion BMS pops … Continue reading

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Case 127 – the summary

Thanks for all your input this week, as we worked through the investigation and management of CML; highlighting a few areas for discussion as we went! See below summary notes on CML – mainly taken from the European Leukaemia Network … Continue reading

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Case 127 – The beginning

You are the haematology SpR reviewing routine blood films in the lab at 4pm when you come across the following FBC differential and film from a GP request. The patient is a 31 year old female. Clinical details state ‘for … Continue reading

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Case 126 – Update 1!

  We advised the GP to repeat the asymptomatic 57 year old patient FBC (with film) in 4-6 weeks and to refer to haematology if absolute lymphocyte count was >10 or if he had associated cytopenias / B symptoms / … Continue reading

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Case 126 – The beginning!

You are the on-call haematology registrar who has been contacted by a conscientious GP regarding a fit and well 57 year old man who has an incidental finding of lymphocytosis. The FBC was performed as part of his monitoring for … Continue reading

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Case 124 – Summary

Many thanks for all of your input this week. We covered the case of a 68 year old lady presenting with macrocytic anaemia and thrombocytosis. Key points in initial investigation: Exclude common causes – iron deficiency, B12/folate deficiency, myeloma screen, … Continue reading

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Case 124 – Update 2

Thank you for all of your input and suggestions. To summarise the case thus far: 68 year old lady referred with a macrocytic anaemia and thrombocytosis: Haemoglobin              87 g/L (115 – 165) White cell count          5.2 x 109/L … Continue reading

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Case 124 – Update 1

We are investigating a 68 year old lady referred with a macrocytic anaemia and thrombocytosis. Thanks for all of your helpful input thus far. Tests you have requested to date: Haemoglobin              87 g/L (115 – 165) White cell count … Continue reading

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Case 124 – The beginning

You are helping out in new patient haematology clinic. You have just had your post-lunch coffee and are raring to go! The next patient has been referred via the 2ww pathway by their GP for investigation of an abnormal FBC, … Continue reading

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Case 123

44 year old man present to GP with fatigue, SOB and petechial rash. What investigations would you perform?  Level of urgency?? Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please … Continue reading

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