A 23-year-old female w/ no significant PMHx presents with SOB and RLE pain. She describes it as sudden onset and pleuritic. She does not take any medications including hormonal birth control. She denies any recent surgical history. She is unaware of any family history of clotting or bleeding disorders. Aside from sinus tachycardia, her vitals … Continue reading When do you perform a hypercoagulable workup?
How do you workup hemolytic anemia?
A 42 year old female without history of cirrhosis or renal impairment presents with fatigue and slight yellowing of her skin. She denies any weight loss and shows no evidence of blood loss. Her labs show normocytic anemic with an elevated indirect bilirubin. Otherwise, her comprehensive metabolic panel is relatively unremarkable. Weakness. Jaundice. Anemia. Indirect Hyperbilirubinemia. … Continue reading How do you workup hemolytic anemia?
How do you treat HIT?
On a recent post (When are you concerned about HIT?), we reviewed what you do when suspecting Heparin-induced thrombocytopenia (HIT). Recall, we talked about the mechanism, the clinical presentation, the risk factors, risk stratification and the workup. Pretty informative IMO. So as promised, here is part II, how do you treat HIT? Who do you treat? … Continue reading How do you treat HIT?
How do you approach TLS?
Tumor Lysis Syndrome (TLS) is one of the need-to-know oncologic life-threatening emergencies. Let us dive into a quick review of what you need-to-know. What is the pathophysiology of TLS? Destruction of tumor cells due to a high tumor cell proliferation rate / large tumor burden resulting in high cell turnover ratesdestruction from chemotherapy (usually within … Continue reading How do you approach TLS?
When are you concerned about HIT?
You are reviewing your morning labs and the platelet count is awfully low. You start working through your differentials for thrombocytopenia and as you go through your list, you consider Heparin-induced thrombocytopenia (HIT). You glance over the medication administration record and there it is, your patient has been getting heparin. So should you be concerned … Continue reading When are you concerned about HIT?