Tag Archives: thrombosis

Case 93 – summary

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

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Case 93 – update 4

Our patient has had one left leg DVT which was treated with rivaroxaban. He had no symptoms of malignancy. Two months later he presents again with increased leg swelling and pain and has the thrombosis has increased compared to previous. … Continue reading

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Case 93 – update 3

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

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Case 93 – update 2

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

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Case 93 – update 1

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

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Case 93 – the beginning

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

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Case 86 – part C2

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

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Case 86 – part 3A

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

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Case 68 – update 1

So far we have found out our 36 year old lady has been tired for a few weeks. She has no history of weight loss or night sweats. She has not lost any weight or noted any lumps or bumps. … Continue reading

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Case 66 – summary

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

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 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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Case 39 – update 1

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

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

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