Tag Archives: bleeding history

Case 100 (part D) – summary

The patient had mild thrombocytopenia and has suffered epistaxis. Epistaxis is relatively common and therefore structural causes should also be looked into. This is especially so if the nose bleeds are unilateral. There is a wide differential of why someone … Continue reading

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Case 100 (part D) – update

You repeat the FBC and it shows similar results Hb 141g/l (130-180) MCV 89fl (82-98) WCC 7.5×109/l (4-11) Neutrophils 4.7×109/l (1.7-7.5) Lymphocytes 2.1×109/l  (1.5-4.5) Platelets 70×109/l (150-450) Coagulation screen – normal U&E/LFT – normal Blood film: Questions What is the … Continue reading

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Case 100 (part D) – the beginning

You are a GP evaluating a 12 year old boy with persistent nose bleeds. He otherwise feels well with no past medical history. He is on no medications. FBC shows: Hb 140g/l (130-180) MCV 90fl (82-98) WCC 8.5×109/l (4-11) Neutrophils … Continue reading

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Case 92 – summary

Thanks for your help with the cases. This week we have looked at three different scenarios regarding bleeding or bruising presenting in the paediatric population. The cases although different have some common themes: Coagulation testing in paediatrics is challenging for … Continue reading

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Case 92 – part B

Thanks for your help with case 1 the baby is improving. The following morning you as the Haematology registrar have been referred a 5 year old girl who presented due to parental concern with easy bruising. The bruising was noted … Continue reading

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Case 64 – part 2 – summary

The main aim of this case was to remember that the coagulation screen alone is not suitable for ruling out a bleeding disorder. The most common inherited bleeding disorder frequently will have a normal clotting screens. Indiscriminate clotting screens are … Continue reading

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Case 64 – part 2b

Further questioning of our pre-operative patient reveals she has easy bruising without trauma and has required cauterisation for epistaxis in the past. She bled after a tooth was removed and had to see the dentist following the procedure due to … Continue reading

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Case 64 – part 2a

A 31 year old female is in pre-assessment clinic for an elective laparoscopic cholecystectomy for gallstones. She has no other major medical problems although she does say that she bruises easily after trauma. She also has heavy periods which are managed … Continue reading

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Case 64 – part 1 – summary

We started with a 72 year old gentleman who was having an elective pacemaker insertion. He had an isolated prolonged APTT and we have previously used the following flow chart to make a diagnosis:   It should be remembered that … Continue reading

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Case 64 – part 1c

Our patient has a long APTT and has a haematoma and extensive bruising following pacemaker insertion. He is not on any anticoagulation, but does not have any previous clotting screens to compare to. Given the bleeding history, FFP is administered … Continue reading

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Case 64 – part 1b

The patient with abnormal clotting resulst goes ahead with his planned pacemaker insertion. There is no major bleeding during the procedure but afterwards there is a large haematoma around the pocket with extensive bruising.   Repeat clotting screen shows: PT … Continue reading

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Case 64 – part 1a

This week we’re going to present a series of short cases around clotting results. Hopefully we’ll demonstrate when coagulation screens should be used and also how to interpret basic abnormalities. It most be noted that different labs will use different … Continue reading

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